Immunogenic composition and vaccine for generating an immune response to norovirus

ABSTRACT

An immunogenic composition comprising at least one Norovirus antigen and at least one adjuvant which is at least one B subunit of an AB 5  toxin such as cholera toxin subunit B (CTB) or the B subunit of heat-labile  E. coli  exotoxin LT (LTB).

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a Continuation of U.S. patent application Ser. No. 16/969,423, filed Aug. 12, 2020, which is the U.S. National Stage of International Application PCT/EP2019/053699, filed Feb. 14, 2019, which designates the U.S. and was published by the International Bureau in English on Aug. 22, 2019, and which claims the benefit of European Patent Application No. 18 157 031.8, filed Feb. 15, 2018 and European Patent Application No. 18 215 676.0, filed Dec. 21, 2018; all of which are hereby incorporated herein in their entirety by reference.

REFERENCE TO AN ELECTRONIC SEQUENCE LISTING

The contents of the electronic sequence listing (070313-0045SEQLST.xml; Size: 13,626 bytes; and Date of Creation: Mar. 3, 2023) is herein incorporated by reference in its entirety.

FIELD OF THE INVENTION

The present invention relates to an immunogenic composition comprising one or more norovirus (NoV) antigen(s) and an adjuvant, in particular to a composition comprising one or more NoV antigen and cholera toxin B (CTB) and/or E. coli heat-labile enterotoxin B subunit (LTB) as adjuvant. The present invention also relates to an immunogenic composition comprising one or more norovirus (NoV) antigen(s) and one or more bacterial antigen(s) that is subunit B of a bacterial exotoxin. In addition, the present invention relates to an anti-NoV vaccine comprising the immunogenic composition and to methods of preventing, treating or reducing severity of a NoV infection or for conferring immunity to NoV infections in a human subject. Further, the present invention relates to an immunogenic composition, and an anti-NoV vaccine comprising the immunogenic composition, for use in a method of preventing, treating or reducing severity of gastroenteritis caused by a NoV infection in a subject.

BACKGROUND OF THE INVENTION

Noroviruses are the leading cause of gastroenteritis outbreaks worldwide. They are responsible for 685 million cases annually including 200 million cases among children 5 years old or younger (www.cdc.gov/norovirus/worldwide.html). Up to date, there is no norovirus vaccine on the market. Also, there are no established protocols for norovirus cultivation, which significantly slows down progress of norovirus vaccine development. In addition, the rapid rate of the genetic changes of circulating noroviruses leads to new norovirus strains emerging every 2-4 years, causing epidemic outbreaks and complicating the development of vaccines and therapies that are required to counter these challenges (de Graaf, M, van Beek, J, & Koopmans, P G, 2016, Nature Rev Microbiol, 14: 421-433). It is evident that genogroup GI and GII representatives have been the main causes of the majority of outbreaks in the last two decades (Matthews et al., 2012, Epidemiol. Infect, 140: 1161-1172) with prevalence of the GII genogroup genotype 4 (GII.4). For example, since 2014, appearance of new GII.17 strains has been described in East Asia as well as re-emergence of old GII.4 strains (Chan et al, 2015, Nat Commun, doi: 10.1038/ncomms10061; Choi et al, 2017, Food Environ Virol, doi: 10.1007/s12560-017-9278-4). This constantly changing landscape adds complexity to defining an efficient vaccine composition, as the most preferred approach is a multivalent vaccine. Current norovirus vaccine development relies on use of virus-like particles (VLPs) subunit vaccines (for most recent reviews please see: Tan, M. & Jiang, X., 2014, Hum. Vaccin Immunother, 10:1449-1456; Debbink, K., Lindesmith, L. & Baric, R. S., 2014, Clin Infect Dis, 58:1746-1752; Ramani, S., Estes, M. K. & Atmar, R. L., 2016, PLoS Pathog, 12:e1005334). There is significant progress in accumulating clinical data on norovirus VLP-based vaccine safety and immunogenicity (Ball et al, 1999, Gastroenterology, 117:40-48; Tacket et al, 2003, Clin Immunol, 108:241-247; Lindesmith et al, 2015, PLoS Med, 12:e1001807). The first VLP bivalent vaccine (GI.2+GII.4 VLPs or strains) has reached phase IIb clinical trials (Reference NCT02669121 in clinical trials database https://clinicaltrials.gov/ct2/show/NCT02669121) and several others are under development in pre-clinical research (Springer, M J, et al., 2016, Vaccine, 34:1452-1458; Ball, J. et al., 2017, PLOS One, 12: e0177310; for review see Cortes-Penfield, N W, et al., 2017, Clin. Ther., pii: S0149-2918(17)30769-5).

A recent publication of the results of a randomized, controlled, double-blind clinical trial in healthy adults demonstrated that some tested adjuvants (MPL, alum) do not have an effect on immunogenicity, do not prevent interference between different Norovirus genotypes in the mixture of different VLPs, but can be used (e.g. alum) to stabilize norovirus VLPs (Leroux-Roels, G (2018), The Journal of Infectious Diseases. 217(4), 597-607, doi: 10.1093/infdis/jix572. [Epub ahead of print]). In addition, it is known that alum induces good Th2 responses, but has little capacity to stimulate cellular Th1 immune responses. Also, alum as adjuvant can cause increased IgE production, allergenicity (Gupta et al., 1995, In: Powel M F, Newman M J (eds). Vaccine design: The subunit and adjuvant approach. NY, Plenum Press, 229-248; Goto, N, et al., 1993, Vaccine, 11:914-918; Bergfors E, et al., 2005, Eur J Pediatr., 164:691-697) and cytotoxicity. Despite the fact that alum-based vaccines are generally well-tolerated, alum has long-lasting biopersistence in the body, ability to migrate in lymphoid organs and accumulate in brain, which is raising concerns. For a review of alum as adjuvant and its side effects, see: Petrovsky, N & Aguilar, J C., 2004, Immunol. & Cell Biol., 82:488-496; Gherardi R K, et al., 2014, Front Neurol, 6:4; Gherardi R K, et al, 2016, Morphologie, 100:85-94.

Use of VP1 antigens in the form of highly immunogenic VLPs opened opportunities for partially addressing the above problems. However, up to date, the progress with vaccine development is rather slow and more efforts are required to deal with the issue by offering new immunogenic compositions that can provide reliable protection from noroviral infection. Finding a suitable nontoxic adjuvant that can further improve VLP-containing vaccine performance and replace or, at least, reduce the amount of alum in vaccine formulations would help to address this task. It would be an advantage, if an adjuvant of proteinaceous nature, when used at higher doses, can also serve as antigen by triggering an immune response against itself and provide protection or lower severity of gastroenteritis caused by a pathogen other than norovirus, preferably a bacterial pathogen.

Another problem in the prior art is the following dilemma. For providing broad spectrum immunity against norovirus infections, vaccines containing antigen mixtures, such as an antigen from a genogroup I norovirus and an antigen from a genogroup II norovirus were considered. However, interference of the antigen response to one antigen due to the presence of a second antigen is frequently observed. As a consequence, it is difficult to achieve the broad spectrum immunity intended by combining two or more antigens. It would thus be desirable to achieve antigenic compositions and vaccines comprising two or more different antigens, wherein interference of immune response between the antigens is suppressed.

It is therefore an object of the invention to provide antigenic compositions, and vaccines containing them, that are antigenic against norovirus (NoV) antigens and, optionally, also against bacterial pathogens. It is also an object to provide antigenic compositions, and vaccines containing them, that can protect subjects from NoV infection or that can prevent and/or treat NoV infections, or that reduce the severity of a NoV infection. It is also an object to provide antigenic compositions, and vaccines containing them, that can protect subjects from NoV infection by genogroup I and genogroup 11 NoV or that can prevent and/or treat NoV infections by genogroup I and genogroup II NoV, or that reduce the severity of a NoV infection by genogroup I and genogroup II NoV. It is a further object to provide antigenic compositions, and vaccines containing them, that provide balanced humoral and cellular immune response. It is a further object to provide antigenic compositions, and vaccines containing them, that are sufficiently immunogenic even if they contain a low content of alum as adjuvant or no alum at all, and/or that suppress interference of multiple antigens contained in the composition or vaccine. It is a further object to provide an immunogenic composition and vaccine for increasing the Th1 immune response in a subject against the antigen(s) in the composition or vaccine.

GENERAL DESCRIPTION OF THE INVENTION

Accordingly, the present invention provides the following:

-   -   (1) An immunogenic composition comprising at least one norovirus         antigen and an adjuvant.     -   (2) The immunogenic composition according to items (1), wherein         said at least one norovirus antigen is or comprises a norovirus         VP1 protein.     -   (3) The immunogenic composition according to any one of         items (1) or (2), said immunogenic composition comprising an         antigen of a genogroup I norovirus and an antigen of a genogroup         II norovirus.     -   (4) The immunogenic composition according to any one of         items (1) to (3), wherein said immunogenic composition comprises         norovirus virus-like particles (norovirus VLPs) comprising or         consisting of said at least one norovirus antigen.     -   (5) The immunogenic composition according to any one of         items (1) to (4), wherein said immunogenic composition comprises         VLPs of a genogroup I norovirus and VLPs of a genogroup II         norovirus.     -   (6) The immunogenic composition according to any one of         items (1) to (5), wherein said immunogenic composition comprises         VLPs comprising, preferably consisting of, a norovirus genogroup         I antigen and VLPs comprising, preferably consisting of, a         norovirus genogroup II antigen.     -   (7) The immunogenic composition according to any one of         items (1) to (6), wherein said adjuvant is cholera toxin B         (CTB).     -   (8) The immunogenic composition according to item (7), wherein         said composition contains said at least one norovirus antigen         and said CTB in a mass ratio range of from 1:0.1 to 1:5,         preferably from 1:0.2 to 1:3, more preferably of from 1:0.5 to         1:2.     -   (9) The immunogenic composition according to any one of         items (7) and (8), wherein said CTB is pentameric CTB.     -   (10) The immunogenic composition according to any one of         items (1) to (9), wherein said immunogenic composition comprises         a further adjuvant.     -   (11) The immunogenic composition according to item (10), wherein         said further adjuvant is alum.     -   (12) The immunogenic composition according to any one of         items (1) to (10), wherein said composition does not contain         added aluminum salt such as alum.     -   (13) The immunogenic composition according to item (10) or (11),         wherein said CTB and said further adjuvant are present in a mass         ratio range of from 1:200 to 10:1, preferably of from 1:100 to         5:1, more preferably of from 1:30 to 1:1.     -   (14) The immunogenic composition according to any one of         items (1) to (13), comprising Norovirus VLPs as antigen and CTB         as an adjuvant.     -   (15) The immunogenic composition according to any one of         items (1) to (14), comprising VLPs comprising or consisting of a         genogroup I noroviral antigen, VLPs comprising or consisting of         a genogroup II noroviral antigen, and CTB as an adjuvant.     -   (16) The immunogenic composition according to any one of         items (1) to (15), comprising VLPs comprising or consisting of a         genotype I.1 or 1.4 noroviral antigen, VLPs comprising or         consisting of a genotype II.4 noroviral antigen, and CTB as an         adjuvant.     -   (17) The immunogenic composition according to any one of item         (15), comprising said genogroup I noroviral antigen and said         genogroup II noroviral antigen in a mass ratio range of from 1:1         to 1:6, preferably of from 1:1.5 to 1:5, more preferably of from         1:2 to 1:4.     -   (18) The immunogenic composition according to item (16),         comprising said genotype I.1 or 1.4 noroviral antigen and said         genotype II.4 noroviral antigen in a mass ratio range of from         1:1 to 1:6, preferably of from 1:1.5 to 1:5, more preferably of         from 1:2 to 1:4.     -   (19) The immunogenic composition according to item (1), wherein         said adjuvant is a B subunit of an AB₅ toxin, such as the B         subunit of cholera toxin (CTB) and/or the B subunit of E. coli         heat-labile enterotoxin (LTB).     -   (20) The immunogenic composition according to item (19), wherein         said B subunit of an AB₅ toxin is a protein defined according to         any one or more or all of items (A) to (1) below, and/or wherein         said B subunit of an AB₅ toxin is a protein as defined according         to any one or more or all of items (A′) to (I′) below.     -   (21) The immunogenic composition according to any one or more of         items (7) to (9), (13) to (16), (20), (22), (24), and (28),         wherein said composition is free of the A subunit of said CTB,         said LTB, or said AB₅ toxin.     -   (22) An immunogenic composition comprising norovirus virus-like         particles (norovirus VLPs), preferably VLPs of a genogroup I         norovirus and/or VLPs of a genogroup II norovirus, and at least         one B subunit of an AB₅ toxin as adjuvant.     -   (23) The immunogenic composition according to item (22), wherein         said VLPs comprise or consist of (a) NoV antigen(s) as defined         in items (a) to (k) below.     -   (24) The immunogenic composition according to item (21) or (22),         wherein said B subunit of an AB₅ toxin is CTB that is a protein         as defined in any one of items (A) to (1) below, or said B         subunit of an AB₅ toxin is LTB that is a protein as defined in         any one of items (A′) to (I′) below, preferably said B subunit         is said CTB.     -   (25) The immunogenic composition according to any one of         items (22) to (24), said immunogenic composition comprising VLPs         comprising, preferably consisting of, norovirus genogroup I         antigen(s) and VLPs comprising, preferably consisting of,         norovirus genogroup II antigen(s).     -   (26) The immunogenic composition according to item (25), wherein         said norovirus genogroup I antigen(s) is/are genotype I.4         antigens and said norovirus genogroup II antigen(s) is/are         genotype II.4 antigens.     -   (27) The immunogenic composition according to any one of         items (1) to (26) for use in a method of preventing and/or         treating Norovirus infection in a mammal, preferably in a human.     -   (28) An immunogenic composition for use in a method of         preventing and/or treating Norovirus infection and infection by         a bacterial pathogen in a mammal, preferably in a human, said         immunogenic composition comprising a noroviral antigen as         defined in any of items (1) to (26) and a B subunit of a         bacterial AB₅ toxin capable of generating an immune response         against said bacterial pathogen.     -   (29) The immunogenic composition for the use according to         item (27) or (28), wherein the use comprises parenteral         administration of the immunogenic composition to a subject.     -   (30) The immunogenic composition for the use according to item         (29), wherein said parenteral administration is intravenous         administration.     -   (31) The immunogenic composition for the use according to item         (29), wherein said parenteral administration is intradermal,         intramuscular or subcutaneous administration.     -   (32) The immunogenic composition for the use according to item         (31), wherein said immunogenic composition is preferably as         defined in any one of items (24), (25) and (26).     -   (33) The immunogenic composition for the use according to         item (27) or (28), wherein the use comprises intranasal, oral,         sublingual or buccal administration of the immunogenic         composition to a subject.     -   (34) An anti-norovirus vaccine or a pharmaceutical composition,         comprising the immunogenic composition according to any one of         items (1) to (33) and preferably a pharmaceutically acceptable         carrier.     -   (35) The anti-norovirus vaccine or a pharmaceutical composition         according to item (34), for use in a method of treating or         preventing norovirus infection or for reducing severity of         norovirus infection in a subject, such as by parenteral         administration, notably by intradermal, intramuscular or         subcutaneous administration.     -   (36) The anti-norovirus vaccine or a pharmaceutical composition         according to item (34) or (35), for use in a method of treating         or preventing or reducing the severity of, preferably         preventing, gastroenteritis caused by NoV infection.     -   (37) The norovirus vaccine or pharmaceutical composition         according to item (34), (35) or (36) that is capable of         improving the Th1 immune response against the antigen(s) or of         increasing the ratio of the Th1 immune response to the The2         immune response against the antigen(s) in a subject.     -   (38) A single-dose dosage form of an anti-norovirus vaccine         comprising the anti-norovirus vaccine according to any one of         items (34) to (37) and a pharmaceutically acceptable carrier,         said dosage form comprising from 10 to 1000 μg, preferably from         30 to 300 μg, more preferably from 55 to 150 μg of said at least         one or more Norovirus antigen(s).     -   (39) A vaccine for use in preventing or treating norovirus         infection and infection by a bacterial pathogen, said vaccine         comprising at least one norovirus antigen according to any one         of the preceding items and a B subunit of an AB₅ toxin capable         of generating an immune response against said bacterial         pathogen.     -   (40) The vaccine according to item (39), wherein said bacterial         pathogen is selected from the group of Vibrio cholerae and E.         choli.     -   (41) A method of preventing or treating norovirus infection,         comprising administering to a subject the immunogenic         composition as defined in any one of items (1) to (33) or a         vaccine according to item (34), (35), (36), (37) or (39) or a         single dosage form according to (38).     -   (42) Use of a B subunit of a bacterial AB₅ toxin for reducing         interference of the immune response in a subject against a         noroviral genogroup I antigen by a noroviral genogroup II         antigen. These antigens may be present in an immunogenic         composition comprising the noroviral genogroup I antigen and the         noroviral genogroup II antigen.     -   (43) The use of item (42), wherein said B subunit of a bacterial         AB₅ toxin is CTB or LTB, preferably as defined in item (21)         and/or (24).     -   (44) The immunogenic composition according to any one of         items (1) to (33), wherein said composition does not contain an         A subunit of an AB₅ toxin and does not contain an aluminum salt         (e.g. aluminum hydroxide, alum).     -   (45) Use of a B subunit of a bacterial AB₅ toxin for improving         the Th1 immune response against an immunogenic composition         comprising one or more norovirus antigen(s) as defined in any         one of items (1) to (33) in a subject, preferably for increasing         the ratio of the Th1 immune response to the Th2 immune response         in a subject to said one or more norovirus antigen(s).

The immunogenic compositions of the invention comprise, apart from at least one norovirus antigen, at least one B subunit of an AB₅ toxin, such as CTB or LTB. The present inventors have found immunogenic compositions, and vaccines containing them, that are immunogenic against norovirus (NoV) antigens and have surprisingly high immunogenic activity, particularly if administered parenterally. In particular, the antigenic compositions and vaccines of the invention have high ability to generate NoV GI-specific serum antibodies that block the binding of NoV VLPs to pig gastric mucin (PGM) as a source of histo-blood group antigens (HBGA). The inventors have also found that use of CTB or LTB as adjuvant allows obtaining a more balanced Th1/Th2 immune response compared to immunogenic compositions not containing it and/or compared to immunogenic compositions containing alum as adjuvant. The B subunit of AB₅ toxins, such as CTB or LTB, stimulates much stronger Th1 immune response than alum, particularly if administered parenterally. This is a surprising finding, as according to Estes et al. (J. Inf. Diseases, 18 (2000) S367-S373), use of CT as adjuvant for oral delivery of norovirus VLPs leads to stronger Th2 immune response. Th1 cells generate responses against intracellular parasites such as bacteria and viruses, Th2 cells produce immune responses against extracellular parasites (Mosmann T R et al., 1986, J Immunol., 136:2348-2357; O'Garra A & Arai N, 2000, Trends Cell Biol., 10:542-550). Strong Th1 immune response is an important quality parameter for antiviral vaccines like vaccine against noroviruses.

The inventors have further found that the adjuvant used in the invention reduces and reverses an inhibitory effect (interference) on an immune response to a NoV antigen of a first genogroup or genotype by co-administration of a NoV antigen of a second genogroup or genotype, and can additionally boost the humoral immune response. In particular, the inventors have found that the adjuvant used in the invention reduces and reverses an inhibitory effect on an immune response to a NoV genogroup I antigen by co-administration of a NoV genogroup II antigen.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 : The upper panel illustrates the result of norovirus (NoV) GI.4-specific serum IgG titers after two (at day 0 and day 21) intramuscular (IM) immunizations of BALB/c mice with a mixture of GI.4 (Chiba) and GII.4 (Aomori) VLPs (1 mkg dose each) alone or formulated with a recombinant CTB (rCTB, 1 mkg (microgram, μg)) or aluminum hydroxide (Al(OH)₃, 50 mkg). The mid panel shows kinetics of NoV GI.4-specific IgG immune response development in the pooled sera of mice immunized as described above and measured in ELISA. The lower panel illustrates the ability of NoV GI.4-specific serum antibodies to block the binding of GI.4 VLPs to pig gastric mucin (PGM) as a source of histo-blood group antigens (HBGA). Blocking index (%) was calculated as follows: 100%−(OD[with serum]/OD[without serum]×100%).

FIG. 2 : Upper panel illustrates the result of norovirus (NoV) GII.4-specific serum IgG titers after two (at day 0 and day 21) intramuscular (IM) immunizations of BALB/c mice with a mixture of GI.4 (Chiba) and GII.4 (Aomori) VLPs (1 mkg dose each) alone or formulated with a recombinant CTB (rCTB, 1 mkg) or aluminum hydroxide (Al(OH)₃, 50 mkg). Mid panel shows kinetics of NoV GII.4-specific IgG immune response development in the pooled sera of mice immunized as described above and measured in ELISA. Lower panel illustrates the ability of NoV GII.4-specific serum antibodies to block the binding of GII.4 VLPs to pig gastric mucin (PGM) as a source of histo-blood group antigens (HBGA). Blocking index (%) was calculated as follows: 100%−(OD[with serum]/OD[without serum]×100%).

FIG. 3 : Upper panel illustrates the result of norovirus (NoV) GI.4-specific serum IgG titers after two (at day 0 and day 21) intradermal (ID) immunizations of BALB/c mice with a mixture of GI.4 (Chiba) and GII.4 (Aomori) VLPs (1 mkg dose each) alone or formulated with a recombinant CTB (rCTB, 1 mkg) or aluminum hydroxide (Al(OH)₃, 50 mkg). Mid panel shows kinetics of NoV GII.4-specific IgG immune response development in the pooled sera of mice immunized as described above and measured in ELISA. Lower panel illustrates the ability of NoV GII.4-specific serum antibodies to block the binding of GII.4 VLPs to pig gastric mucin (PGM) as a source of histo-blood group antigens (HBGA). Blocking index (%) was calculated as follows: 100%−(OD[with serum]/OD[without serum]×100%).

FIG. 4 : Upper panel illustrates the result of norovirus (NoV) GII.4-specific serum IgG titers after two (at day 0 and day 21) intradermal (ID) immunizations of BALB/c mice with a mixture of GI.4 (Chiba) and GII.4 (Aomori) VLPs (1 mkg dose each) alone or formulated with a recombinant CTB (rCTB, 1 mkg) or aluminum hydroxide (Al(OH)₃, 50 mkg). Mid panel shows kinetics of NoV GII.4-specific IgG immune response development in the pooled sera of mice immunized as described above and measured in ELISA. Lower panel illustrates the ability of NoV GII.4-specific serum antibodies to block the binding of GII.4 VLPs to pig gastric mucin (PGM) as a source of histo-blood group antigens (HBGA). Blocking index (%) was calculated as follows: 100%−(OD[with serum]/OD[without serum]×100%).

FIG. 5 : Upper panel illustrates the result of norovirus (NoV) GI.4-specific serum IgG titers after two (at day 0 and day 21) intranasal (IN) immunizations of BALB/c mice with a mixture of GI.4 (Chiba) and GII.4 (Aomori) VLPs (1 mkg dose each) alone or formulated with a recombinant CTB (rCTB, 1 mkg). Mid panel shows kinetics of NoV GI.4-specific IgG immune response development in the pooled sera of mice immunized as described above and measured in ELISA. Lower panel illustrates the ability of NoV GI.4-specific serum antibodies to block the binding of GI.4 VLPs to pig gastric mucin (PGM) as a source of histo-blood group antigens (HBGA). Blocking index (%) was calculated as follows: 100%−(OD[with serum]/OD[without serum]×100%).

FIG. 6 : Upper panel illustrates the result of norovirus (NoV) GII.4-specific serum IgG titers after two (at day 0 and day 21) intranasal (IN) immunizations of BALB/c mice with a mixture of GI.4 (Chiba) and GII.4 (Aomori) VLPs (1 mkg dose each) alone or formulated with a recombinant CTB (rCTB, 1 mkg). Mid panel shows kinetics of NoV GII.4-specific IgG immune response development in the pooled sera of mice immunized as described above and measured in ELISA. Lower panel illustrates the ability of NoV GII.4-specific serum antibodies to block the binding of GII.4 VLPs to pig gastric mucin (PGM) as a source of histo-blood group antigens (HBGA). Blocking index (%) was calculated as follows: 100%−(OD[with serum]/OD[without serum]×100%).

FIG. 7 : Figure illustrates the result of norovirus (NoV) GI.4-specific (FIG. 7A) and GII.4-specific (FIG. 7B) serum IgG1 and IgG2a titers after two (at day 0 and day 21) intramuscular (IM) immunizations of BALB/c mice with a mixture of GI.4 (Chiba) and GII.4 (Aomori) VLPs (1 mkg dose each) alone or formulated with a recombinant CTB (rCTB, 1 mkg). As positive control mixture of VLPs with 50 mkg of Al(OH)₃ was used.

FIG. 8 : Figure illustrates the result of norovirus (NoV) GI.4-specific (FIG. 8A) and GII.4-specific (FIG. 8B) serum IgG1 and IgG2a titers after two (at day 0 and day 21) intradermal (ID) immunizations of BALB/c mice with a mixture of GI.4 (Chiba) and GII.4 (Aomori) VLPs (1 mkg dose each) alone or formulated with a recombinant CTB (rCTB, 1 mkg). As positive control mixture of VLPs with 50 mkg of Al(OH)₃ was used.

FIG. 9 : Homologous norovirus (NoV) VP1 antigen-specific serum IgG and blocking activity in subcutaneously (SC) immunized mice. Individual, serially diluted serum samples were analysed for antibody levels at week 5 in ELISA against GI.4 (A) and GII.4 Aomori (C). Group-wise pooled and two-fold titrated serum samples were tested for genotype-specific blocking (neutralizing) activity against GI.4 (B) and GII.4 (D) VLPs using pig gastric mucin (PGM)-based blocking assay. The blocking index (%) was calculated as 100%−[(OD wells with VLP and serum/OD wells without serum, “maximum binding”)×100%]. Immunizations of BALB/c mice with a mixture of GI.4 (Chiba) and GII.4 (Aomori) VLPs (10 mkg dose each or 10 mkg GI.4 and 35 mkg of GII.4) alone or formulated with a recombinant CTB (rCTB, 10 mkg). As positive control mixture of VLPs with 50 mkg of Al(OH)₃ was used.

FIG. 10 : Homologous norovirus (NoV) VP1 antigen-specific serum IgG and blocking activity in intramuscularly (IM) immunized mice. Individual, serially diluted serum samples were analysed for antibody levels at week 5 in ELISA against GI.4 (A) and GII.4 Aomori (C). Group-wise pooled and two-fold titrated serum samples were tested for genotype-specific blocking (neutralizing) activity against GI.4 (B) and GII.4 (D) VLPs using pig gastric mucin (PGM)-based blocking assay. The blocking index (%) was calculated as 100%−[(OD wells with VLP and serum/OD wells without serum, “maximum binding”)×100%]. Immunizations of BALB/c mice with a mixture of GI.4 (Chiba) and GII.4 (Aomori) VLPs (10 mkg dose each or 10 mkg GI.4 and 35 mkg of GII.4) alone or formulated with a recombinant CTB (rCTB, 10 mkg). As positive control mixture of VLPs with 50 mkg of Al(OH)₃ was used.

FIG. 11 : Cross-blocking of GII.4-99 NoV VLP binding in saliva HBGA-based assay. Pooled serum of immunized groups was analyzed for the ability to block binding of GII.4-1999 VLP to saliva HBGAs. The blocking index (%) was calculated as 100%−[(OD wells with VLP and serum/OD wells without serum, “maximum binding”)×100%]. All vaccine doses (except X—35 mkg of GII.4 only, and XVI-PBS) contain 10 mkg of GI.4+35 mkg of GII.4 VLPs. XI and XII, in addition to VLPs contain 50 mkl of Al(OH)₃; XIII and XIV contain 10 mkg of CTB.

FIG. 12 : Serum IgG titers after two (at day 0 and day 21) intramuscular (IM) immunizations of BALB/c mice with a mixture of GI.4 (Chiba) and GII.4 (Aomori) VLPs (1 or 10 mkg dose each) alone or formulated with plant-made recombinant CTB (CTB, 1 or 10 mkg) alone or in combination with aluminum hydroxide (Al(OH)₃, 50 mkg). Left panel shows NoV GI.4-specific IgG immune responses, middle panel shows NoV GII.4-specific IgG immune responses, right panel—CTB-specific IgG immune responses.

DETAILED DESCRIPTION OF THE INVENTION

Noroviruses are non-enveloped single-stranded positive-sense RNA viruses. They belong to the family Calciviridae. A key structural component of norovirus particles is the VP1 protein. The size of the NoV particle varies between 23 and 40 nm in diameter. Depending on the size, the number of VP1 molecules per viral particle is generally either 60 or 180 molecules (http://viralzone.expasy.org/194). There are five different genogroups of noroviruses (GI, Gil, Gill, GIV, and GV) that can be further divided into genotypes. Examples of noroviruses are Norwalk virus (GenBank: AF093797.1), GI.1 strain Aichi/124-89/JP (GenBank: BAA834130), GI.2 strain Funabashi258/96/JP (GenBank: BAC05516), Maryland virus (MV, AY032605), GI.3 strain Shimizu/KK2866/JP (GenBank: A1173765), GII.17 strain C142/1978/GUF (GenBank: AG117592), GI.4 strain Chiba407/87/JP (GenBank: BAA82106), GI.7 strain TCH-060/USA/2003 (GenBank: AEQ77282), GII.4 strain NL/2014/GII.4/Groningen01 (GeneBank: CRL46961), GII.4 strain Aomori2/2006/JP (GenBank: BAG70446), GIV.1 strain Ahrenshoop246/DEU/2012 (GenBank: AFN61315), GII.17 strain JP/2002/Saitama/T87 (GenBank: AII73747), Jena virus (JV, AJ01099), GII.4 strain Sydney/NSW0514/2012/AU (GenBank: AFV08795), GII.3 strain Kashiwa336/00/JP (GenBank: AAZ66774), GII.17 strain JP/2013//Saitama5203 (GenBank: BAR63715), Seto virus (GenBank: AB031013). There are many other norovirus strains the complete genomes of which are annotated in publicly available databases (www.viprbrc.org). Table 1A and B list several NoV strains.

NoV Antigen(s) of the Invention

The immunogenic composition of the invention comprises at least one norovirus (NoV) antigen and at least one adjuvant. A NoV antigen according to the invention is a protein. The NoV antigen is generally a NoV capsid protein or a fragment or derivative thereof. NoV capsid proteins are the VP1 and the VP2 protein, whereby the VP1 protein, fragments and derivatives thereof are preferred for use as an antigen in the present invention, as they may form virus-like particles (VLPs). However, VP2 may also be contained in the immunogenic composition. Table 1B contains the amino acid sequences of VP1 proteins of several NoV strains (SEQ ID NOs 1 to 78). As can be seen, there is considerable variability among VP1 proteins. Thus, the antigen and VP1 protein of the invention are not limited to any specific antigen or VP1 protein of a NoV occurring in nature, but cover fragments, derivatives and fusion proteins of such specific antigen or VP1 protein.

The NoV antigen or the VP1 protein of the invention may be a protein

-   -   (a) the amino acid sequence of which consists of an amino acid         sequence selected from any one of SEQ ID NOs: 1 to 78; or     -   (b) the amino acid sequence of which consists of an amino acid         sequence of at least 300, preferably at least 400, more         preferably at least 450, even more preferably at least 500         contiguous amino acid residues of an amino acid sequence         selected from any one of SEQ ID NOs: 1 to 78; or     -   (c) the amino acid sequence of which comprises an amino acid         sequence of at least 300, preferably at least 400, more         preferably at least 450, even more preferably at least 500         contiguous amino acid residues of an amino acid sequence         selected from any one of SEQ ID NOs: 1 to 78: or     -   (d) the amino acid sequence of which has an amino acid sequence         identity of at least 70%, preferably at least 80%, more         preferably at least 85%, even more preferably at least 90%, and         most preferably at least 95%, to an amino acid sequence selected         from any one of SEQ ID NOs: 1 to 78; or     -   (e) the amino acid sequence of which has a length of at least         300 amino acid residues, said amino acid sequence having an         amino acid sequence identity of at least 70%, preferably at         least 80%, more preferably at least 85%, even more preferably at         least 90%, and most preferably at least 95%, to at least a         segment of at least 300 contiguous amino acid residues of an         amino acid sequence selected from any one of SEQ ID NOs: 1 to         78; or     -   (f) the amino acid sequence of which has a length of at least         400, preferably at least 450, amino acid residues, said amino         acid sequence having an amino acid sequence identity of at least         70%, preferably at least 80%, more preferably at least 85%, even         more preferably at least 90%, and most preferably at least 95%,         to at least a segment of at least 400, preferably at least 450,         respectively, contiguous amino acid residues of an amino acid         sequence selected from any one of SEQ ID NOs: 1 to 78; or     -   (g) the amino acid sequence of which has a length of at least         500 amino acid residues, said amino acid sequence having an         amino acid sequence identity of at least 70%, preferably at         least 80%, more preferably at least 85%, even more preferably at         least 90%, and most preferably at least 95%, to at least a         segment of at least 500 contiguous amino acid residues of an         amino acid sequence selected from any one of SEQ ID NOs: 1 to         78; or     -   (h) the amino acid sequence of which has from 1 to 100,         preferably from 1 to 80, more preferably from 1 to 60, more         preferably from 1 to 40, more preferably from 1 to 30, more         preferably from 1 to 20, even more preferably from 1 to 10,         amino acid residue deletions, substitutions, additions or         insertions compared to an amino acid sequence selected from any         one of SEQ ID NOs: 1 to 78; or     -   (i) the amino acid sequence of which has a length of at least         300 amino acid residues and has from 1 to 100, preferably from 1         to 80, more preferably from 1 to 60, more preferably from 1 to         40, more preferably from 1 to 30, more preferably from 1 to 20,         even more preferably from 1 to 10, amino acid deletions,         substitutions, additions or insertions compared to a segment of         at least 300 contiguous amino acid residues of an amino acid         sequence selected from any one of SEQ ID NOs: 1 to 78; or     -   (j) the amino acid sequence of which has a length of at least         400, preferably at least 450, amino acid residues and has from 1         to 100, preferably from 1 to 80, more preferably from 1 to 60,         more preferably from 1 to 40, more preferably from 1 to 30, more         preferably from 1 to 20, even more preferably from 1 to 10,         amino acid deletions, substitutions, additions or insertions         compared to a segment of at least 400, preferably at least 450,         respectively, contiguous amino acid residues of an amino acid         sequence selected from any one of SEQ ID NOs: 1 to 78; or     -   (k) the amino acid sequence of which has a length of at least         500 amino acid residues and has from 1 to 100, preferably from 1         to 80, more preferably from 1 to 60, more preferably from 1 to         40, more preferably from 1 to 30, more preferably from 1 to 20,         even more preferably from 1 to 10, amino acid deletions,         substitutions, additions or insertions compared to a segment of         at least 500 contiguous amino acid residues of an amino acid         sequence selected from any one of SEQ ID NOs: 1 to 78.

The antigen or protein defined above may have a maximum length in terms of number of amino acid residues of 550 amino acid residues, preferably 520 amino acid residues.

SEQ ID NOs: 1 to 78 are also referred to herein as “reference sequences”. A definition following the wording “protein the amino acid sequence of which . . . ” defines the entire amino acid sequence of the protein (not just a part thereof). The expression “an amino acid sequence selected from any one of SEQ ID NOs: 1 to 78” means the entire amino acid sequence of any one of SEQ ID NOs: 1 to 78, respectively, unless explicit reference is made to a “segment” or “portion”. A “segment” or “portion” of an amino acid sequence is a partial sequence (or fragment) of contiguous amino acid residues of any given number of amino acid residues of the amino acid sequence which is referred to. The length of an amino acid sequence is measured by the number of amino acid residues it consists of. Amino acid sequence identities may be determined by protein sequence search and alignment programs freely accessible from internet, for example PROTEIN BLAST (https://blast.ncbi.nlm.nih.gov/Blast.cgi?PAGE=Proteins) and ExPASy (http://web.expasy.org/sim/. A comprehensive list of sequence alignment tools can be found at http://molbiol-tools.ca/Alignments.htm.

The NoV antigen may be a NoV VP1 protein of any NoV genogroup, a fragment of such protein, a derivative of the protein or the fragment, or a protein comprising an amino acid sequence of a NoV VP1 protein or derivative, as defined above in items (a) to (k). Preferably, the antigen is an antigen of genogroups I, 11 or IV, especially a VP1 protein of genogroups I, 11 or IV.

The antigen or protein may have amino acid deletions, substitutions, additions or insertions compared to the reference sequences indicated above. Among these, deletions, substitutions, and additions are preferred. The number(s) of such alterations indicated above refer to the sum of all deletions, substitutions, additions and insertions. The term “insertion” relates to insertions within the amino acid sequence of a reference sequence, i.e. excluding additions at the C- or N-terminal end. The term additions means additions at the C- or N-terminal end of the amino acid sequence of a reference sequence. A deletion may be a deletion of a terminal or an internal amino acid residue of a reference sequence.

A fragment of a protein antigen such as of the NoV VP1 protein may be any protein fragment having a length of at least 300, preferably at least 400, more preferably at least 450, and even more preferably at least 500 contiguous amino acid residues of a VP1 protein of any NoV found in nature or those given in Table 1B. A fragment may be as defined in item (b) above, but having less amino acid residues than the reference sequence. If, as is preferred, the composition contains VLPs as an antigen, the antigen forming the VLPs must have a sufficient length to form VLPs. Whether VLPs are formed can be determined by established methods such as by electron microscopy (Laue M & Bannert N., 2010, J Applied Microbiol., 109:1159-1168; Harris J R, 1999, Methods Mol Biol., 117:13-30; Pogan R et al., 2018, J Phys.: Condens. Matter, 30: 064006) or by size exclusion chromatography (Effio C L et al., 2016, Vaccine, 34:1259-1267).

A derivative or derivative of a fragment of a VP1 protein may be as defined above in any one of items (d) to (k). A protein comprising a NoV antigen or VP1 protein, or a fragment or derivative thereof may be a fusion protein comprising the antigen or VP1 protein, fragment or derivative, respectively, and an added domain or sequence stretch such as a signal sequence or a purification tag. Such added domain or sequence stretch may be added at the N- or C-terminus of the VP1 protein, fragment or derivative, and may consist of not more than 30, preferably not more than 20, more preferably not more than 10 amino acid residues. It is also possible that the antigen contains a covalently bound non-proteinaceous covalent modification, such as a PEGylation.

A NoV antigen for use in the invention, such as the VP1 protein or a fragment or derivative thereof, may be from any NoV found in nature, preferably an antigen is an antigen of NoV genogroups I, 11 or IV. The antigen may be of any NoV genogroup and/or any genotype, such as those listed in Table 1A or B. In one embodiment, the NoV antigen is from a genogroup I NoV. In another embodiment, the NoV antigen is from a genogroup II NoV. Among these genogroups, the composition of the invention may contain at least an antigen of a NoV of genogroup II. A given NoV antigen of any one of the above items (a) to (k) is considered a NoV antigen of the genogroup and/or genotype indicated in Table 1A or 1B for the SEQ ID NO for which the definition of items (a) to (k) applies. Where a given NoV antigen may, according to the definition of items (a) to (k), belong to more than one genogroup or genotype, it is an antigen of the genogroup or genotype to which it has a higher sequence identity, e.g. over the entire length of the respective reference sequence.

A NoV antigen of genogroup I may be a protein

-   -   (a′) the amino acid sequence of which comprises or consists of         an amino acid sequence selected from any one of SEQ ID NOs: 1 to         22; or     -   (b′) the amino acid sequence of which consists of an amino acid         sequence of at least 300, preferably at least 400, more         preferably at least 500 contiguous amino acid residues of an         amino acid sequence selected from any one of SEQ ID NOs: 1 to         22; or     -   (c′) the amino acid sequence of which comprises an amino acid         sequence of at least 300, preferably at least 400, more         preferably at least 500 contiguous amino acid residues of an         amino acid sequence selected from any one of SEQ ID NOs: 1 to         22; or     -   (d′) the amino acid sequence of which has an amino acid sequence         identity of at least 70%, preferably at least 80%, more         preferably at least 85%, even more preferably at least 90%, and         most preferably at least 95% to an amino acid sequence selected         from any one of SEQ ID NOs: 1 to 22; or     -   (e′) the amino acid sequence of which has a length of at least         300 amino acid residues, said amino acid sequence having an         amino acid sequence identity of at least 70%, preferably at         least 80%, more preferably at least 85%, even more preferably at         least 90%, and most preferably at least 95%, to at least a         segment of at least 300 contiguous amino acid residues of an         amino acid sequence selected from any one of SEQ ID NOs: 1 to         22; or     -   (f′) the amino acid sequence of which has a length of at least         400, preferably at least 450, amino acid residues, said amino         acid sequence having an amino acid sequence identity of at least         70%, preferably at least 80%, more preferably at least 85%, even         more preferably at least 90%, and most preferably at least 95%,         to at least a segment of at least 400, preferably at least 450,         respectively, contiguous amino acid residues of an amino acid         sequence selected from any one of SEQ ID NOs: 1 to 22; or     -   (g′) the amino acid sequence of which has a length of at least         500 amino acid residues, said amino acid sequence having an         amino acid sequence identity of at least 70%, preferably at         least 80%, more preferably at least 85%, even more preferably at         least 90%, and most preferably at least 95%, to at least a         segment of at least 500 contiguous amino acid residues of an         amino acid sequence selected from any one of SEQ ID NOs: 1 to         22; or     -   (h′) the amino acid sequence of which has from 1 to 100,         preferably from 1 to 80, more preferably from 1 to 60, more         preferably from 1 to 40, more preferably from 1 to 30, more         preferably from 1 to 20, even more preferably from 1 to 10,         amino acid deletions, substitutions, additions or insertions         compared to an amino acid sequence selected from any one of SEQ         ID NOs: 1 to 22; or     -   (i′) the amino acid sequence of which has a length of at least         300 amino acid residues and having from 1 to 100, preferably         from 1 to 80, more preferably from 1 to 60, more preferably from         1 to 40, more preferably from 1 to 30, more preferably from 1 to         20, even more preferably from 1 to 10, amino acid deletions,         substitutions, additions or insertions compared to a segment of         at least 300 contiguous amino acid residues of an amino acid         sequence selected from any one of SEQ ID NOs: 1 to 22; or     -   (j′) the amino acid sequence of which has a length of at least         400, preferably at least 450, amino acid residues and has from 1         to 100, preferably from 1 to 80, more preferably from 1 to 60,         more preferably from 1 to 40, more preferably from 1 to 30, more         preferably from 1 to 20, even more preferably from 1 to 10,         amino acid deletions, substitutions, additions or insertions         compared to a segment of at least 400, preferably at least 450,         respectively, contiguous amino acid residues of an amino acid         sequence selected from any one of SEQ ID NOs: 1 to 22; or     -   (k′) the amino acid sequence of which has a length of at least         500 amino acid residues and has from 1 to 100, preferably from 1         to 80, more preferably from 1 to 60, more preferably from 1 to         40, more preferably from 1 to 30, more preferably from 1 to 20,         even more preferably from 1 to 10, amino acid deletions,         substitutions, additions or insertions compared to a segment of         at least 500 contiguous amino acid residues of an amino acid         sequence selected from any one of SEQ ID NOs: 1 to 22.

A NoV antigen of genogroup II may be a protein as defined in above items (a′) to (k′) except that the wording “an amino acid sequence selected from any one of SEQ ID NOs: 1 to 22” is replaced by “an amino acid sequence selected from any one of SEQ ID NOs: 23 to 75”. A NoV antigen of genogroup IV may be a protein as defined in above items (a′) to (k′) except that the wording “an amino acid sequence selected from any one of SEQ ID NOs: 1 to 22” is replaced by “an amino acid sequence selected from any one of SEQ ID NOs: 76 to 78”.

An antigen of genogroup I may be of any one or more of the following genotypes: 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.8, or 1.9. An antigen of genogroup 11 may be an antigen of any one or more of the following genotypes: 11.1, 11.2, 11.3, 11.4, 11.5, 11.6, 11.7, 11.8, 11.12, 11.13, 11.14, 11.17, 11.21, 11.22, 11.24, or 11.25. An antigen of genogroup IV may be an antigen of any one or more of the following genotypes: IV.1 or IV.3.

A NoV antigen of genotype I.1 (GI.1) may be a protein as defined in above items (a′) to (k′) except that the wording “an amino acid sequence selected from any one of SEQ ID NOs: 1 to 22” is replaced by “an amino acid sequence selected from any one of SEQ ID NOs: 5 or 6”. A NoV antigen of any other genotype listed in Table 1B is defined accordingly by substituting the SEQ ID NO of the previous sentence by those given in Table 1A or 1B for the respective genotype. For example, a NoV antigen of genotype I.4 (GI.4) may be a protein as defined in above items (a′) to (k′) for the amino acid sequence of SEQ ID NO: 13 or 14. A NoV antigen of genotype II.4 may be a protein as defined in above items (a′) to (k′) for the amino acid sequence selected from any one of SEQ ID NOs: 40-54. A NoV antigen of genotype II.6 may be a protein as defined in above items (a′) to (k′) for the amino acid sequence selected from any one of SEQ ID NOs: 56-58.

Among NoV antigens of genogroup I, those of genotype I.1 and 1.4 are preferred, those of genotype I.4 are more preferred. Among NoV antigens of genogroup II, those of genotypes II.1 (GII.1), 11.4 (GII.4), 11.6 (GII.6), and 11.17 (GII.17) are preferred, those of genotypes II.1 (GII.1), 11.4 (GII.4), and 11.6 (GII.6) are more preferred, and those of genotype II.4 are even more preferred in the present invention.

Adjuvant Used in the Invention

The immunogenic composition of the invention comprises, apart from the at least one NoV antigen, at least one adjuvant (also referred to as “vaccine adjuvant”). Adjuvants are pharmacological or immunological agents that boost the immune response after administration to a subject, which generally leads to higher titer of antibodies and longer-lasting immune protection. Adjuvants may also modulate the immune response, for example may affect the balance between cellular and humoral immune responses. Vaccine adjuvants are described in numerous research publications as well as in review articles (Lee S. & Nguen M T., 2015, Immune Netw., 15:51-57; Di Pasquale A et al., 2015, Vaccines, 3:320-343; Cimica, V, & Galarza, J M., 2017, Clin. Immunol., 183:99-108; McKee A S & Marrack P., 2017, Curr. Opin. Immunol., 47:44-51). However, only few adjuvants are currently used in vaccines that are approved for use in humans. These adjuvants include aluminum salts, oil-in water emulsions (MF59 and AS03), and a few more have been tested in clinical trials (CpG, Flagellin, Polyl:C, AS1, AS2, ISCOS and ISCOMMATRIX (Lee S. & Nguen M T., 2015, Immune Netw., 15:51-57). Adjuvants are frequently classified by their mode of action and/or preferred route of application. Following their mode of action, some of the adjuvants belong to the group of Toll-like Receptor (TLR) agonists. Examples of adjuvants or adjuvant classes are: TLR (toll-like receptor) agonists such as CpG (TLR9 agonist), poly (U) (TLR7/8 agonist), bacterial endotoxin derivatives like monophosphoryl lipid A or MPLA (TLR4 agonist), etc.

Bacterial exotoxins and their fusions can also act as adjuvants in a vaccine composition. Some bacterial exotoxins have been used in immunogenicity studies. These include Cholera toxin (CT) that is produced by the bacterium Vibrio cholerae and consists of two subunits: the toxic subunit A (CTA) and the non-toxic subunit B (CTB) that forms a homopentameric structure (Lemcer, W I & Tsai, B. 2003, Trends Biochem. Sci., 28:639-645; Chinnapen, D J, et al., 2007, FEMS Microbiol. Le., 266:129-137; Wemick, N L, et al., 2010, Toxins 2:310-325). Another bacterial exotoxin that is identical or very similar in terms of tertiary and quaternary structure to CT is heat-labile enterotoxin of E. coli (LT). CT and LT are highly homologous and show about 80% of homology. For review of CT-like enterotoxins, please refer to Basset, C et al., 2010, Toxins, 2:1774-17795. Like CT, LT also consists of two subunits—the toxic subunit A (LTA) and the non-toxic subunit B (LTB) that forms a pentameric structure. Non-toxic LT mutants and derivatives thereof can serve as adjuvants (for review, please refer to Ma, Y, 2016, Expert Rev. Vaccines, 15:1361-1371). The LT and CT can be structurally classified and are known in the art as AB₅ multimeric proteins or AB₅ toxins and consist of single catalytic A subunit and pentameric B oligomer (Burnett, W N, 1994, Structure, 2:151-158). For a review on AB₅ toxins, reference is made to Merritt, E A & Hol, W G., 1995, Curr. Opin. Struct. Biol., 5:165-171; Beddoe T, et al., 2010 Trends Biochem. Sci., 35:411-418.

LTB, like CTB, was successfully used in animal studies as mucosal adjuvant and for parenteral administration, as fusion with antigen of interest (Zhang, J, et al., 2016, Vaccine, 34:622-629; Marchioro, S B, et al., 2014, Vaccine, 32:4689-4694). Clinical trials to evaluate safety and immunogenicity of orally delivered vaccine against enterotoxigenic Escherichia coli (ETEC), composed of inactivated recombinant E. coli expressing increased levels of ETEC colonization factors and LTB/CTB hybrid protein showed that presence of hybrid LTB/CTB protein does not change the safety profile, but increases the strength and quality of the immune responses (Lundgren, A, et al., 2013, Vaccine, 31:1163-1170). Use of bacterial exotoxins as mucosal adjuvants in combination with norovirus antigens was described in the past, for heat-labile E. coli toxin LT and its non-toxic mutant R192G (Nicollier-Jamot, B, et al., 2004, Vaccine, 22:1079-86; Clements, J D & Norton, E B, 2018, mSphere, 3:e00215-18). U.S. Pat. No. 7,527,801 describes the use of the non-toxic LT mutants LTK63 or LTR72. In this invention, preference is given not to mutant versions of exotoxins, but to their B subunits of, preferably, recombinant origin and to parenteral delivery route of administration of the vaccine in the absence of the A subunit.

In one embodiment of the invention, the adjuvant (or co-antigen) used is a CTB. The CTB usable in the invention may be a protein

-   -   (A) the amino acid sequence of which comprises or consists of an         amino acid sequence selected from any one of SEQ ID NOs: 79 to         96; or     -   (B) the amino acid sequence of which consists of an amino acid         sequence of at least 90, preferably at least 100 amino acid         residues of an amino acid sequence selected from any one of SEQ         ID NOs: 79 to 96; or     -   (C) the amino acid sequence of which comprises an amino acid         sequence of at least 90, preferably at least 100 contiguous         amino acid residues of an amino acid sequence selected from any         one of SEQ ID NOs: 79 to 96; or     -   (D) the amino acid sequence of which has an amino acid sequence         identity of at least 85%, preferably at least 90%, more         preferably at least 95%, to an amino acid sequence selected from         any one of SEQ ID NOs: 79 to 96; or     -   (E) the amino acid sequence of which has a length of at least 90         amino acid residues, said amino acid sequence having an amino         acid sequence identity of at least 85%, preferably at least 90%,         more preferably at least 95%, to at least a segment of at least         90 contiguous amino acid residues of an amino acid sequence         selected from any one of SEQ ID NOs: 79 to 96; or     -   (F) the amino acid sequence of which has a length of at least         100 amino acid residues, said amino acid sequence having an         amino acid sequence identity of at least 85%, preferably at         least 90%, more preferably at least 95%, to at least a segment         of at least 100 contiguous amino acid residues of an amino acid         sequence selected from any one of SEQ ID NOs: 79 to 96; or     -   (G) the amino acid sequence of which has from 1 to 15,         preferably from 1 to 10, more preferably from 1 to 5, and even         more preferably from 1 to 3, amino acid residue deletions,         substitutions, additions or insertions compared to an amino acid         sequence selected from any one of SEQ ID NOs: 79 to 96; or     -   (H) the amino acid sequence of which has a length of at least 90         amino acid residues and has from 1 to 15, preferably from 1 to         10, more preferably from 1 to 5, and even more preferably from 1         to 3, amino acid deletions, substitutions, additions or         insertions compared to a segment of at least 90 contiguous amino         acid residues of an amino acid sequence selected from any one of         SEQ ID NOs: 79 to 96; or     -   (I) the amino acid sequence of which has a length of at least         100 amino acid residues and having from 1 to 15, preferably from         1 to 10, more preferably from 1 to 5, and even more preferably         from 1 to 3, amino acid deletions, substitutions, additions or         insertions compared to a segment of at least 100 contiguous         amino acid residues of an amino acid sequence selected from any         one of SEQ ID NOs: 79 to 96.

In another embodiment of the invention, the adjuvant (or co-antigen) used is an LTB. The LTB usable in the invention may be a protein

-   -   (A′) the amino acid sequence of which comprises or consists of         an amino acid sequence selected from any one of SEQ ID NOs: 97         to 100; or     -   (B′) the amino acid sequence of which consists of an amino acid         sequence of at least 90, preferably at least 100 amino acid         residues of an amino acid sequence selected from any one of SEQ         ID NOs: 97 to 100; or     -   (C′) the amino acid sequence of which comprises an amino acid         sequence of at least 90, preferably at least 100 contiguous         amino acid residues of an amino acid sequence selected from any         one of SEQ ID NOs: 97 to 100; or     -   (D′) the amino acid sequence of which has an amino acid sequence         identity of at least 85%, preferably at least 90%, more         preferably at least 95%, to an amino acid sequence selected from         any one of SEQ ID NOs: 97 to 100; or     -   (E′) the amino acid sequence of which has a length of at least         90 amino acid residues, said amino acid sequence having an amino         acid sequence identity of at least 85%, preferably at least 90%,         more preferably at least 95%, to at least a segment of at least         90 contiguous amino acid residues of an amino acid sequence         selected from any one of SEQ ID NOs: 97 to 100; or     -   (F′) the amino acid sequence of which has a length of at least         100 amino acid residues, said amino acid sequence having an         amino acid sequence identity of at least 85%, preferably at         least 90%, more preferably at least 95%, to at least a segment         of at least 100 contiguous amino acid residues of an amino acid         sequence selected from any one of SEQ ID NOs: 97 to 100; or     -   (G′) the amino acid sequence of which has from 1 to 15,         preferably from 1 to 10, more preferably from 1 to 5, and even         more preferably from 1 to 3, amino acid residue deletions,         substitutions, additions or insertions compared to an amino acid         sequence selected from any one of SEQ ID NOs: 97 to 100; or     -   (H′) the amino acid sequence of which has a length of at least         90 amino acid residues and has from 1 to 15, preferably from 1         to 10, more preferably from 1 to 5, and even more preferably         from 1 to 3, amino acid deletions, substitutions, additions or         insertions compared to a segment of at least 90 contiguous amino         acid residues of an amino acid sequence selected from any one of         SEQ ID NOs: 97 to 100; or     -   (I′) the amino acid sequence of which has a length of at least         100 amino acid residues and having from 1 to 15, preferably from         1 to 10, more preferably from 1 to 5, and even more preferably         from 1 to 3, amino acid deletions, substitutions, additions or         insertions compared to a segment of at least 100 contiguous         amino acid residues of an amino acid sequence selected from any         one of SEQ ID NOs: 97 to 100.

The definitions given above with regard to the wording of items (a) to (k) also apply to the above items (A) to (I) and (A′) to (I′). As above, a “segment” or “portion” of an amino acid sequence is a partial sequence (or fragment) of contiguous amino acid residues of any given number of amino acid residues of the amino acid sequence of a reference sequence. The length of an amino acid sequence is measured by the number of amino acid residues it consists of. Amino acid sequence identities may be determined as described above in the context of the antigen of the invention. Similarly, sequence identities are determined as defined above. Also, the above definitions regarding amino acid deletions, substitutions, additions or insertions as defined above apply analogously.

Preferably, the CTB used in the invention such as those defined in items (A) to (1) above has a pentameric quaternary structure, e.g. as CTB does in CT. Whether CTB forms a pentameric quaternary structure, as opposed to being monomeric, can be determined using MALDI mass spectroscopy, non-denaturing gel chromatography or by size-exclusion chromatography. These methods are known to the skilled person. In another embodiment, the CTB is monomeric CTB.

Two or more variants of the CTB as defined above may be combined in an immunogenic composition of the invention. In such case, any amounts or mixing ratios disclosed herein refer to the sum of all CTB variants according to the invention.

Similarly, the LTB used in the invention such as those defined in items (A′) to (I′) above has a pentameric quaternary structure, e.g. as LTB does in LT. Whether LTB forms a pentameric quaternary structure, as opposed to being monomeric, can be determined using MALDI mass spectroscopy, non-denaturing gel chromatography or by size-exclusion chromatography. These methods are known to the skilled person. In another embodiment, the LTB is monomeric LTB.

Two or more variants of the LTB as defined above may be combined in an immunogenic composition of the invention. In such case, any amounts or mixing ratios disclosed herein refer to the sum of all LTB variants according to the invention.

In a further alternative, one or more CTB as defined above may be combined with one or more LTB as defined above in an immunogenic composition of the invention. In such case, any amounts or mixing ratios disclosed herein refer to the sum of all LTB and all CTB variants.

Examples of amino acid sequences of the CTB for use in the invention are provided in Table 2. Examples of amino acid sequences of the LTB for use in the invention are provided in Table 3. Modifications such as mutations may be made to alter some properties of the CTB or LTB, such as expression yield, or to express it in a desired compartment of the cell or plant where it is expressed. Further or alternatively, a purification tag may be added.

Use of CTB as vaccine adjuvant or as antigen as well as antigen fusion is described in review articles (Holgren, J, et al., 1994, Am. J. Trop. Med. Hyg., 50:42-54; Lebens, M. & Holmgren, J. 1994, Dev. Biol. Stand., 82:215-227; Sun, J B., et al., 2010, Scand. J. Immunol., 71:1-11; Baldauf K J, et al., 2015, Toxins, 7:974-996: Stratmann, T., 2015, Vaccines, 3, 579-596). CTB is usually used in vaccines for mucosal (predominantly oral or intranasal) route of delivery. CTB is known to trigger humoral immune responses in vaccines administered via the mucosal route (Holmgren et al., 2005, Immunol. Lett., 97:181-188; Holgren et al., 2003, Expert Rev. Vaccines, 2:205-217). A similar effect of Cholera Toxin applied as mucosal adjuvant with plant-made Norwalk virus VLPs was shown (Velaskuez et al., 2010, Clinical & Vaccine Immunol., 17:1850-1858). However, use of CTB as adjuvant in combination with baculovirus-produced noroviral VLPs does not seem to increase mucosal immune responses when delivered orally (Huo, Y et al., 2015, Mol. Immunol., 68:367-72). Similar data were obtained for intranasal delivery of plant-made VLPs in combination with recombinant CTB (Flarebio Biotech LLC, USA) (please refer to Example 4, FIGS. 5 and 6 ).

Surprisingly, as found in the present invention, NoV antigens such as NoV VLPs with CTB showed much better results when delivered parenterally (such as intramuscular (IM), subcutaneous (SC) or intradermal (ID)). The immune responses were comparable to and sometimes higher than the immune responses produced by formulations with much higher content (in terms of mass) of aluminum hydroxide (see Examples 1 and 2, FIGS. 1-4 ). Similar vaccines and dosages applied by the mucosal route of delivery produced much weaker immune responses. The inventors have found that use of the B subunit of an AB₅ toxin, such as CTB, as adjuvant with norovirus antigens, notably VLPs, for parenteral delivery (intradermal, subcutaneous or intramuscular) increases the strength and quality of immune response in comparison with norovirus VLPs alone or in combination with Al(OH)₃. The invention therefore also provides antigenic compositions and vaccines that do not contain alum or contain alum in lower amounts than in the prior art (Leroux-Roels et al. (2018), The Journal of Infectious Diseases. 217(4), 597-607).

Accordingly, the B subunit of a bacterial AB₅ toxin such as CTB or LTB can be used for reducing interference of the immune response in a subject against a noroviral genogroup I antigen by a noroviral genogroup II antigen. These antigens may be present in an immunogenic composition comprising the noroviral genogroup I antigen and the noroviral genogroup II antigen.

Accordingly, the B subunit of a bacterial AB₅ toxin can also be used, as component of an immunogenic composition comprising one or more NoV antigens as described therein, for preventing and/or treating Norovirus infection and infection by a bacterial pathogen in a mammal, preferably in a human. Further, the B subunit of a bacterial AB₅ toxin can be used for improving the Th1 immune response to an immunogenic composition comprising one or more norovirus antigen(s) as defined herein in a subject. Preferably, the B subunit of a bacterial AB₅ toxin can be used for increasing the ratio of the Th1 immune response to the Th2 immune response, in a subject, to the one or more norovirus antigen(s) described herein. In these uses, CTB or LTB are the preferred B subunits of the AB₅ toxin.

CTB for use in the invention can be obtained from commercial sources. CTB can be expressed as wild-type or mutated versions with enhanced properties, e.g. yield, stability, post-translational modifications, or in the form of fusions to antigens in a variety of organisms, including prokaryotes like E. coli or eukaryots like green plants (Miata, T., et al., 2012, Vaccine; 30(28):4225-32; Hamorsky, K T., et al., 2013, PLoS Negl Trop Dis., 7(3):e2046; Hamorsky, K T., et al., 2015, Sci Rep. 2015 Jan. 23; 5:8003; Stratmann, T., 2015, Vaccines, 3, 579-596). Further, CTB may be expressed in plants analogously as described below for the antigen and in EXAMPLE 6. This allows any modification or mutation desired to be made such as those given in Table 2. In an important embodiment of the invention, the immunogenic composition or vaccine does not contain alum (aluminum hydroxide).

LTB for use in the invention can be obtained from commercial sources (for example, supplied by Merck recombinant LTB produced in Pichia pastoris, Cat. No. E8656). LTB can be expressed as wild-type or mutated versions with enhanced properties, e.g. yield, stability, post-translational modifications, or in the form of fusions to antigens in a variety of organisms, including prokaryotes like E. coli or eukaryotes like yeasts and green plants (Pillai, D, et al., 1996, FEBS Lett., 387:23-26; Lim, J G, et al., 2009, J. Microbiol. Biotechnol., 19:502-510; Wagner, B, et al., 2004, J. Immunol. Methods, 287:203-215; Sim, J S, et al., 2009, Plant Mol. Biol. Rep., 27:388-399; Soh, H S, et al., 2015, SpringerPlus, 4:148). Further, LTB may be expressed in plants analogously as described below for the antigen and in EXAMPLE 6. This allows any modification or mutation desired to be made such as those given in Table 3.

Immunogenic Composition of the Invention

The immunogenic composition of the invention comprises at least one NoV antigen and an adjuvant. It may comprise two or more different NoV antigens, such as two or more VP1 proteins, in order to generate immune responses in a mammal against multiple NoV antigens at the same time, such as three different NoV antigens. The NoV antigen(s) used in the composition of the invention depend on the NoV or NoVs against which immunization in a mammal should be achieved using the vaccine of the invention. As NoVs that cause infections in mammals evolve, the antigen(s) used in the composition may be changed or adapted so as to cause immune response in a subject against the NoVs considered a health risk. As mentioned above, composition of the invention may contain a NoV antigen from any NoV genogroup such as GI, GII or GIV. The composition may contain one NoV antigen from any of these genogroups. However, if it contains only one antigen, this antigen may be from genogroup II, since NoV of this genogroup has more frequently caused health risks in past years. Preferably, the composition of the invention comprises two or more different NoV antigens that may be antigens of two or more different NoV genogroups. In preferred embodiments, the immunogenic composition of the invention comprises at least two NoV antigens from two different NoV genogroups, preferably an antigen from a NoV genogroup I and an antigen of a NoV genogroup II. In a further embodiment, the immunogenic composition comprises two or more antigens from one NoV genogroup, preferably of genogroup II. An antigen from any genogroup I NoV listed in Table 1A or 1B may be combined with an antigen from any genogroup II NoV listed in Table 1A or 1B in the composition (and vaccine) of the invention. It is of course possible to add a further antigen from a genogroup 1, genogroup II or another genogroup (e.g. those of Table 1A or B) to the composition of the invention.

Regarding genotypes of the antigens to be used in the composition of the invention, there are no particular limitations. Preferred genotypes of genogroup I are genotypes I.1 and I.4. Preferred genotype of genogroup II are genotypes II.4 and II.17. A more preferred genotype of genogroup II is genotype II.4. If the composition of the invention contains antigens from both genogroups I and II, an antigen from genotype I.4 and an antigen of genotype II.4 may be combined. As above, the antigens are preferably VP1 proteins. If the composition of the invention contains two or more NoV antigens or VP1 proteins, each may be as defined in items (a) to (k) above.

With regard to embodiments wherein an antigen from NoV genogroup I is combined with an antigen from NoV genogroup II, the following examples of immunogenic compositions may be mentioned:

-   -   a composition comprising an antigen of genotype I.1 and an         antigen of genotype II.1;     -   a composition comprising an antigen of genotype I.1 and an         antigen of genotype II.4;     -   a composition comprising an antigen of genotype I.1 and an         antigen of genotype II.6;     -   a composition comprising an antigen of genotype I.4 and an         antigen of genotype II.1;     -   a composition comprising an antigen of genotype I.4 and an         antigen of genotype II.4;     -   a composition comprising an antigen of genotype I.4 and an         antigen of genotype II.17;     -   a composition comprising an antigen of genotype I.4 and an         antigen of genotype II.2;     -   a composition comprising an antigen of genotype I.1 and an         antigen of genotype II.17;     -   a composition comprising an antigen of genotype I.1 and an         antigen of genotype II.2; and     -   a composition comprising an antigen of genotype I.4 and an         antigen of genotype II.6.

Preferred is an embodiment, wherein the immunogenic composition contains an antigen of genotype I.1 or 1.4 (GI.4) and an antigen of genotype II.4 (GII.4) or 11.17. More preferred is an embodiment, wherein the immunogenic composition contains an antigen of genotype I.1 or 1.4 (GI.4) and an antigen of genotype II.4 (GII.4). In all these embodiments, the immunogenic compositions further contain one or more adjuvants as described herein.

As mentioned above, the immunogenic composition may, in a further embodiment, comprises two or more antigens from one NoV genogroup, preferably of genogroup II. The immunogenic composition may comprise two different antigens of genogroup II noroviruses, such as an antigen of a first genotype of a genogroup II norovirus and an antigen of a second genotype of a genogroup II norovirus. For example, the composition may comprise an antigen (e.g. VP1 protein) of a genotype II.1 NoV and an antigen (e.g. VP1 protein) of a genotype II.4 NoV. Alternatively, the composition may comprise an antigen (e.g. VP1 protein) of a genotype 11.1 NoV and an antigen (e.g. VP1 protein) of a genotype II.17 NoV. Alternatively, the composition may comprise an antigen (e.g. VP1 protein) of a genotype II.4 NoV and an antigen (e.g. VP1 protein) of a genotype II.17 NoV. A NoV antigen of genogroup II may be a protein as defined in above items (a′) to (k′) except that the wording “an amino acid sequence selected from any one of SEQ ID NOs: 1 to 22” is replaced by “an amino acid sequence selected from any one of SEQ ID NOs: 23 to 75”. Antigens of genotypes II.1, 11.4 and 11.17 may be selected from these SEQ ID NOs.

Derivatives of an antigen as defined above (e.g. in items (b) to (k)) are considered antigens of the genogroup and/or genotype to which the native antigen (e.g. of SEQ ID NOs 1 to 78) belongs. If an antigen such as a VP1 protein may, using this rule, belong to two different genogroups or genotypes, the antigen or derivative belongs to the genogroup or genotype to which the antigen or derivative is most similar in terms of amino acid sequence identity over the entire length of an amino acid sequence of a native VP1 protein such as of any one of SEQ ID NOs 1 to 78.

The immunogenic composition of the invention preferably contains NoV virus-like particles (norovirus VLPs or NoV VLPs) as the antigen(s). VLPs are viral particles consisting of virus structural protein(s), but do not contain viral nucleic acid. In the case of norovirus, VLPs consist of structural protein(s) VP1 or of VP1 and VP2 proteins (or any fragments or derivatives as described herein). The VLPs used in the invention comprise or consist of NoV capsid proteins as antigens, notably VP1 as defined herein. The VLPs may comprise or consists of a protein as defined in any one of items (a) to (k) above. Thus, the proteins of items (a) to (k) above are preferably capable of forming VLPs. Herein, a VLP comprises generally at least 60 VP1 molecules, preferably at least 80 VP1 molecules, more preferably at least 100 VP1 molecules. In a more preferred embodiment, a VLP comprises at least 60 protein molecules as defined in any one of items (a) to (k), preferably at least 80 protein molecules as defined in any one of items (a) to (k), more preferably at least 100 protein molecules as defined in any one of items (a) to (k).

The immunogenic composition of the invention may comprise the genogroup I noroviral antigen and the genogroup II noroviral antigen in a mass ratio range of from 1:1 to 1:6, preferably of from 1:1.5 to 1:5, more preferably of from 1:2 to 1:4. In another embodiment, the immunogenic composition of the invention comprises the genogroup I noroviral antigen and the genogroup II noroviral antigen in a mass ratio range of from 3:1 to 1:3, preferably of from 2:1 to 1:2, and more preferably of from 1.5:1 to 1:1.5, and even more preferably of from 1.2:1 to 1:1.2.

VLPs may comprise a protein as defined in any one of items (a) to (k) above and a further component. The further component may be a NoV VP2 protein or another (i.e. a different) NoV antigen as defined in any one of items (a) to (k). It is possible that a VLP contains two different antigens as defined in any one of items (a) to (k). However, if two or more different antigens are to be included in the composition as VLPs, it is preferred that VLPs of the first antigen are combined with VLPs of a second antigen, since this allows better control of the content of the two antigens in the immunogenic composition.

As described above, the immunogenic composition of the invention preferably contains antigens from two or more (or three or more) different NoV genogroups, such as an antigen from genogroup I and an antigen of genogroup II. The composition of the invention may contain VLPs comprising or consisting of each of these antigen(s). Preferably, the composition contains VLPs comprising or consisting of a NoV antigen of a first genogroup (e.g. genogroup 1) and VLPs comprising or consisting of a NoV antigen of a second genogroup (e.g. genogroup II). With regard to embodiments wherein VLPs of a NoV antigen from genogroup I is combined with VLPs of an antigen from genogroup II, the following immunogenic compositions may be mentioned as examples:

-   -   a composition comprising VLPs consisting of or comprising an         antigen of genotype I.1 and VLPs consisting of or comprising an         antigen of genotype II.1;     -   a composition comprising VLPs consisting of or comprising an         antigen of genotype I.1 and VLPs consisting of or comprising an         antigen of genotype II.4;     -   a composition comprising VLPs consisting of or comprising an         antigen of genotype I.1 and VLPs consisting of or comprising an         antigen of genotype II.6;     -   a composition comprising VLPs consisting of or comprising an         antigen of genotype I.1 and VLPs consisting of or comprising an         antigen of genotype II.2;     -   a composition comprising VLPs consisting of or comprising an         antigen of genotype I.1 and VLPs consisting of or comprising an         antigen of genotype II.17;     -   a composition comprising VLPs consisting of or comprising an         antigen of genotype I.4 and VLPs consisting of or comprising an         antigen of genotype II.1;     -   a composition comprising VLPs consisting of or comprising an         antigen of genotype I.4 and VLPs consisting of or comprising an         antigen of genotype II.4; and     -   a composition comprising VLPs consisting of or comprising an         antigen of genotype I.4 and VLPs consisting of or comprising an         antigen of genotype II.6.     -   a composition comprising VLPs consisting of or comprising an         antigen of genotype I.4 and VLPs consisting of or comprising an         antigen of genotype II.2;     -   a composition comprising VLPs consisting of or comprising an         antigen of genotype I.4 and VLPs consisting of or comprising an         antigen of genotype II.17;

In a preferred embodiment, the immunogenic composition of the invention contains VLPs of a genotype I.4 antigen and VLPs of a genotype II.4 antigen, whereby each of the antigens may be VP1 proteins. In another embodiment, the immunogenic composition of the invention contains VLPs of a genotype I.1 antigen and VLPs of a genotype II.4 antigen, whereby each of the antigens may be VP1 proteins. In all these embodiments, each antigen may be as defined in items (a) to (k) above (but from the indicated genotype).

The immunogenic composition of the invention may comprise the genogroup I VLPs and the genogroup 11 VLPs in a mass ratio range of from 1:1 to 1:6, preferably of from 1:1.5 to 1:5, more preferably of from 1:2 to 1:4. In another embodiment, the immunogenic composition of the invention comprises the genogroup I VLPs and the genogroup II VLPs in a mass ratio range of from 3:1 to 1:3, preferably of from 2:1 to 1:2, and more preferably of from 1.5:1 to 1:1.5, and even more preferably of from 1.2:1 to 1:1.2.

As described above, the invention also provides immunogenic compositions that comprise two or more antigens from one NoV genogroup, preferably of genogroup II. Accordingly, the immunogenic composition of the invention may comprise VLPs consisting of or comprising an antigen of a first genotype of genogroup II NoV and VLPs consisting of or comprising an antigen of a second genotype of genogroup II NoV. In more detail, the immunogenic composition of the invention may comprise VLPs consisting of or comprising an antigen of genotype II.1 and VLPs consisting of or comprising an antigen of genotype II.4. Alternatively, the immunogenic composition may comprise VLPs consisting of or comprising an antigen of genotype II.1 and VLPs consisting of or comprising an antigen of genotype II.17. Alternatively, the immunogenic composition may comprise VLPs consisting of or comprising an antigen of genotype II.4 and VLPs consisting of or comprising an antigen of genotype II.17.

The invention also provides an immunogenic composition for use in a method of preventing and/or treating Norovirus infection and infection by a bacterial pathogen in a mammal, preferably in a human, said immunogenic composition comprising a noroviral antigen as defined above, preferably NoV VLPs as defined above, and a B subunit of a bacterial AB₅ toxin capable of generating an immune response against said bacterial pathogen. The B subunit of a bacterial AB₅ toxin may be CTB or LTB, preferably CTB, as defined above. Such immunogenic composition may be or may be used as a combination vaccine for preventing and/or treating Norovirus infection and infection by the bacterial pathogen. The amounts of NoV antigen, said B subunit and ratios thereof may be as mentioned herein.

For all embodiments mentioned above, the immunogenic composition of the invention does preferably not contain a nucleic acid encoding a NoV antigen(s).

The immunogenic composition of the invention comprises at least one NoV antigen as described above and at least one adjuvant as described above as components. The compositions are immunogenic in that they generate an immune response against the antigen(s) of the invention if the composition is administered to a mammal, such as a human. Further, a suitable carrier or excipient may be present in said compositions. The composition may be obtained by simply mixing the components, optionally in a suitably carrier, in desired amounts and mixing ratios. A suitable carrier may be water or an aqueous solution that should be at an appropriate pH such as from 6 to 8, preferably from 6.7 to 7.5. The aqueous solution may contain, apart from water, a buffer, a tonicity agent and/or a preservative as required.

The immunogenic composition may contain the at least one NoV antigen and the B subunit of the AB₅ toxin (such as CTB) in a mass ratio range of from 1:0.1 to 1:5, preferably from 1:0.2 to 1:3, more preferably of from 1:0.5 to 1:2. The CTB may be one as defined in items (A) to (1) above. If more than one NoV antigen is present, these values apply to the sum of all NoV antigens. If more than one CTB is present, these values apply to the sum of all CTBs or CTB variants. Where the composition contains LTB, these ratio ranges apply analogously to the LTB.

The composition may contain further desired components, such as an additional adjuvant. An example of an additional adjuvant is aluminum hydroxide (alum) that is a generally know adjuvant for vaccines or other aluminum salts. The composition may contain the CTB and the further adjuvant in a mass ratio range of from 1:200 to 10:1, preferably of from 1:100 to 5:1, more preferably of from 1:30 to 1:1. If more than one additional adjuvant is contained, these values relate to the sum of all adjuvants other than the B subunit of the AB₅ toxin (such as CTB).

Where the composition contains both a B subunit of the AB₅ toxin (such as CTB) and an aluminum salt such as aluminum hydroxide (alum) as the further adjuvant, the composition may contain the B subunit of the AB₅ toxin and the aluminum salt in a mass ratio range of from 1:50 to 20:1, preferably of from 1:20 to 10:1, more preferably of from 1:5 to 5:1, and even more preferably from 1:1 to 5:1. In one embodiment, the immunogenic composition (and the vaccine) does not contain an aluminum salt such as aluminum hydroxide (alum).

Where the composition contains both CTB and an aluminum salt such as aluminum hydroxide (alum) as the further adjuvant, the composition may contain the CTB and the aluminum salt in a mass ratio range of from 1:50 to 20:1, preferably of from 1:20 to 10:1, more preferably of from 1:5 to 5:1, and even more preferably from 1:1 to 5:1. In one embodiment, the immunogenic composition (and the vaccine) does not contain an aluminum salt such as aluminum hydroxide (alum).

The composition may be liquid or solid. If it is liquid, it may be a solution in water or an aqueous buffer. If it is solid, it may be a mixture of the NoV antigen(s), preferably the NoV VLPs of the invention, and the adjuvant (such as CTB) used in the invention. A preferred solid form is a lyophilized form.

For preparing the immunogenic composition of the invention, the one or more antigens, preferably in the form of VLPs, may be mixed with the adjuvant(s) preferably in or with a suitable carrier or medium. Preferably, VLPs comprising or consisting of antigens from a first genogroup or genotype may be mixed with VLPs comprising or consisting of antigens from a second genogroup or genotype with a suitable carrier or medium, followed by addition of the adjuvant(s). The carrier or medium may be water or an aqueous medium such as a solution. The aqueous medium may contain a buffer to control the pH and may contain physiologic saline and/or other additives. The additives can be, but are not limited to, sucrose, glycerol, trehalose. The antigen may be stored in an aqueous medium until the immunogenic composition or the vaccine of the invention are produced. For longer storage times, it may be frozen or lyophilized. After production of the immunogenic composition, it may be sterilized, e.g. by sterile filtration and stored. Storage may be in liquid form or frozen. It may also be stored after lyophilization as a dry powder.

The lyophilization of immunogenic composition and vaccines is well known in the art. Typically the composition is freeze dried in the presence of agents to protect the antigen and/or adjuvant of the invention during the lyophilization process and to yield powders with desirable characteristics. Sugars such as sucrose, mannitol, trehalose, or lactose (present at an initial concentration of 10-200 mg/mL) are commonly used for cryoprotection and lyoprotection of protein antigens and to yield lyophilized cake or powders with desirable characteristics. Lyophilized compositions may be more stable. Other drying technologies, such as spray drying or spray freeze drying may also be used.

The immunogenic composition of the invention does preferably not contain the A subunit of the A_(B) toxin and/or does not contain an aluminum salt (e.g. aluminum hydroxide, alum).

Vaccine of the Invention

The vaccine of the invention comprises the immunogenic composition of the invention in a form suitable for administration to a subject or in a form that can, prior to administration, be easily brought in a form suitable for administration to a subject. For example, the vaccine may be a solid formulation that can be reconstituted prior to administration by addition of a predetermined amount of water or aqueous solution, suspension or emulsion. In general, the vaccine comprises, apart from the immunogenic composition, one or more pharmaceutical excipients or carriers. Excipients may be liquid or solid. Liquid excipients include, without limitation, water, alcohol, saline, and buffered solutions. Other possible excipients include, without limitation, preservatives and other additives such as antimicrobials, anti-oxidants, chelating agents, buffer substances. The immunogenic composition of the invention may itself be a vaccine in the sense of the invention.

The vaccine is an anti-NoV vaccine. It is at the same time a pharmaceutical composition. The vaccine is generally used for preventing or treating NoV infection in a subject, or for suppressing the severity of a NoV infection. The invention also provides a method of preventing or treating norovirus infection, or for suppressing the severity of a NoV infection, generally comprising administering to a subject the immunogenic composition or vaccine of the invention. Subjects in which NoV may be prevented or treated or in which the severity of a NoV infection may be suppressed are mammals, preferably humans. Among humans, both children and adults may be subjects for preventing or treating NoV infection. Among humans, children are preferred for achieving immunization early in life. Human subjects are considered children up to the age of 16. Preferably, the NoV vaccine is used in children of age between 1 and 16, preferably 2 to 14, and more preferably from 3 to 12 years of age.

As the vaccine is generally administered to subjects by injection, the norovirus vaccine is generally a liquid aqueous formulation. However, the norovirus vaccine may also be in solid form such as in a lyophilized form to be reconstituted with water or an aqueous medium before administration.

The vaccine of the invention is preferably administered to a subject parenterally. The parenteral administration may be intravenous, intradermal, intramuscular or subcutaneous administration. Preferred are intradermal, intramuscular or subcutaneous administration, more preferably intradermal and intramuscular administration. In one embodiment, the vaccine is administered intradermally. In another embodiment, the vaccine is administered intramuscularly.

When the vaccine is administered to a human subject, or in the method of the invention, the NoV antigen(s) is (are) administered in an amount of from 10 to 1000 μg, preferably from 30 to 300 μg, more preferably from 55 to 150 μg of NoV antigen. If the vaccine contains more than one NoV antigen, these amounts relate to the sum of the amounts of the individual antigens. If the vaccine contains antigens of genogroup I and antigens of genogroup II, the amount of the genogroup 11 antigen may be the same or higher than that of the genogroup I antigen. The amount of the genogroup 11 antigen(s) may be from 1.5 to 6 times, preferably from 2.0 to 5 times, more preferably from 2.5 to 4.5 times, and even more preferably from 3.0 to 4.0 times the amount of the genogroup I antigen(s) in terms of mass.

The vaccine may be packaged in a single-dose or multiple dose form in a container that contains the desired amount of the vaccine. Preferred are single-dose forms, where the single dose contains the administration amount of NoV antigen as given above. The single-dose form may comprise from 10 to 1000 μg, preferably from 30 to 300 μg, more preferably from 55 to 150 μg of NoV antigen(s). If the vaccine contains antigens of genotype I and antigens of genotype 11, the ratios of these antigens may be as defined in the previous paragraph.

The vaccine may be administered once or twice to a subject for improving the immunity against NoV infection. If the vaccine to be administered twice, the second administration may be made within 2 to 8 weeks, preferably within 3 to 5 weeks after the first administration of the vaccine.

The vaccine of the invention may also contain antigens against other infectious diseases for generating immune protection not only against NoV, but also against other viruses. It may, for example, be considered to include into the vaccine rotavirus antigens to generate protection against NoV and rotavirus.

The inventors have found that the adjuvant of the invention itself acts as an antigen and can generate an immune response in a mammal, preferably a human, against it. The adjuvant of the invention is a B subunit of an AB₅ toxin, such as CTB or LTB. CTB and LTB are proteins that are expressed or can be derived from Vibrio cholerae and E. choli, respectively. This finding opens up the possibility for providing a combination vaccine for preventing and/or treating Norovirus infection and infection by a bacterial pathogen in a mammal, preferably in a human, said vaccine comprising a noroviral antigen as defined in any preceding claims and a B subunit of a bacterial AB₅ toxin capable of generating an immune response against these bacterial pathogens. Regarding excipients, routes of administration, amounts of NoV antigens to be administered, amounts of B subunits to be administered, etc. the conditions mentioned above on the immunogenic composition and vaccine apply also to this embodiment.

In one embodiment, the vaccine does not contain an aluminum salt such as aluminum hydroxide (alum). In another embodiment, the vaccine does not contain the A subunit of the bacterial AB₅ toxin, i.e. is free of the A subunit. In a further embodiment, the vaccine does not contain an aluminum salt such as aluminum hydroxide (alum) and does also not contain the A subunit of the bacterial AB₅ toxin. These preferred embodiments can be combined with other preferred embodiments described herein, e.g. preferred embodiments of the antigens and antigen combinations used.

Herein, the immunogenic composition, vaccine or pharmaceutical composition is considered not to contain the A subunit of the AB₅ toxin (such as CT or LT) or to be free of the A subunit, if the content of the AB₅ protein (toxin) (that contains the A subunit) is at most 1% of the content of the B protein (generally the B₅ pentamer that is composed of only B subunit). The content of the AB₅ protein relative to that of the B protein (or the B₅ pentamer) may be determined by separating the proteins of the B subunit-containing sample, the proteins of the immunogenic composition, or the proteins of the vaccines using non-reducing SDS gel electrophoresis (Laemmli, U. K., 1970, Nature, 227: 680-685), detecting separated B subunit-containing proteins on the Coomassie-stained gel by employing a ChemiDoc™ Imaging System (Bio-Rad) equipped with Image Lab 6.0.1 software, and determining the area under the curve for the bands of the AB₅ protein and B protein (e.g. the B₅ pentamer). The content of the AB₅ protein is considered to be at most 1% of the content of the B protein (e.g. the B₅ pentamer) (i.e. the B subunit-containing sample is free of the A subunit) if the area under the curve of the AB₅ protein is at most 1% of the area under the curve of the B protein(s) (e.g. the B₅ pentamer). The position of the bands of the AB₅ protein and the B protein (e.g. the B₅ protein) on the gel can be determined by the skilled person based on the known molecular weight of these proteins and the position on the gel, optionally with the help of suitable molecular weight markers.

If the composition or vaccine (or a sample) contains two or more different B subunits of AB₅ toxins, the above test may be conducted for each B subunit-containing sample separately or on the same gel. The composition, vaccine or sample is free of the A subunit if the sum of the areas under the curve(s) of the AB₅ proteins is at most 1% of the sum of the areas under the curve(s) of the B proteins.

Production of NoV Antigens

NoV antigens as described above can be expressed in and purified from different production hosts including mammalian cells, insect cells and plants (for review: Herbst-Kralovetz, M., Mason, H. S. & Chen, Q. 2010, Exp. Rev. Vaccines, 9:299-307). Reliable NoV antigen and NoV VLP purification protocols and modifications thereof have been described for insect cells using baculoviral expression system (Jiang, X. et al., 1992, J. Virol., 66:6527-6532; Prasad B V V, Hardy D, Estes M. 2000, J. Infect. Dis., 181:S317-S321; Huhti, L., et al., 2010, Arch. Virol., 155:1855-1858; Koho, T., et al., 2012, J. Virol. Methods, 181:6-11; Huhti, L., et al., 2013, Arch. Virol., 158:933-942; VV02013192604) and for plants (Santi L. et al., 2008, Vaccine, 26:1846-1854; Lai, H. & Chen, Q. 2012, Plant Cell Rep., 31:573-584). EP2601970 may also be considered regarding the production of NoV VLPs. Although there is no difference observed in the structure and immunogenic properties of VLPs isolated from insect and plant cells, a preferred system for VLP production is plant-based, as this allows avoiding baculoviral impurities in the antigen or VLPs isolated from plant tissues. In addition, plant-based transient expression systems, unlike the baculoviral one, are easily scalable. Successful expression of many NoV antigen genes in plants using plant virus-based expression system called magnlCON® (Gleba et al., 2005, Vaccine, 23:17-18; Marillonnet et al., 2005, Nat. Biotechnol., 23:718-723; Gleba et al., Curr. Opin. Biotechnol., 2007, 18:134-141; Klimyuk, V., et al., 2014, Curr. Top. Microbiol. Immunol., 375:127-154) that allows to easily express viral VLPs in Nicotiana benthamiana plants (Zahin, M. et al., 2016, PLoS One, 11(8):e0160995). A list of NoV antigens (VP1 proteins) of various genotpyes, expression of was done in plants and VLPs formation was confirmed is given Table 1B.

In more detail, the antigen of the invention may be produced by known methods of protein expression in a standard expression system. For producing the antigen, a nucleotide sequence encoding it may be expressed in a suitable host organism. Methods usable for producing and purifying a protein of interest have been described in the prior art and any such methods may be used. If a eukaryotic expression system is used, one or more introns may be inserted in the coding sequence of the antigen.

Particularly efficient expression methods are plant expression systems that are also known in the prior art. A possible way of achieving expression of a nucleotide sequence of interest encoding an antigen according to the invention in plants is the use of self-replicating (viral) replicons containing the nucleotide sequence encoding the antigen. Plant viral expression systems have been described in many publications, such as in WO2012019660, WO2008028661, WO2006003018, WO2005071090, WO2005049839, WO2006012906, WO02101006, WO2007137788 or WO02068664 and many more publications are cited in these documents. Various methods for introducing a nucleic acid molecule, such as a DNA molecule, into a plant or plant part for transient expression are known. Agrobacteria may be used for transfecting plants with the nucleic acid molecule (vector) or nucleic acid construct e.g. by agroinfiltration or spraying with agrobacterial suspensions. For references, see WO 2012019660, WO 2014187571, or WO 2013149726.

In embodiments wherein strong expression of the antigen is desired, a nucleic acid construct containing a nucleotide sequence encoding the antigen may encode a viral vector that can replicate in plant cells to form replicons of the viral vector. In order to be replicating, the viral vector and the replicons may contain an origin of replication that can be recognized by a nucleic acid polymerase present in plant cells, such as by the viral polymerase expressed from the replicon. In case of RNA viral vectors (referred to as “RNA replicons”), the replicons may be formed by transcription under the control of a promoter active in plant cells, from the DNA construct after the latter has been introduced into plant cell nuclei. In case of DNA replicons, the replicons may be formed by recombination between two recombination sites flanking the sequence encoding the viral replicon in the DNA construct, e.g. as described in WO00/17365 and WO 99/22003. If the replicon is encoded by the DNA construct, RNA replicons are preferred. Use of DNA and RNA viral vectors (DNA or RNA replicons) has been extensively described in the literature over the years. Some examples are the following patent publications: WO2008028661, WO2007137788, WO 2006003018, WO2005071090, WO2005049839, WO02097080, WO02088369, WO02068664. Examples of DNA viral vectors are those based on geminiviruses. For the present invention, viral vectors or replicons based on plant RNA viruses, notably those based on plus-sense single-stranded RNA viruses may be preferably used. Accordingly, the viral replicon may be a plus-sense single-stranded RNA replicon. Examples of such viral vectors are those based on tobacco mosaic virus (TMV) and potexvirus X (PVX). “Based on” means that the viral vector uses the replication system such as the replicase and/or other proteins involved in replication of these viruses. Potexvirus-based viral vectors and expression systems are described in EP2061890 or WO2008/028661.

The antigen may be expressed in a multi-cellular plant or a part thereof, notably a higher plant or parts thereof. Both monocot and dicot (crop) plants can be used. Common plants usable for expressing proteins include Nicotiana tabacum and Nicotiana benthamiana. However, many others can be employed as well.

Generally, the antigen may be expressed in the cytosol of cells of the plants or plant parts. In this case, no signal peptide directing the protein of interest into a particular compartment is added to the enzyme. Alternatively, the antigen or VP1 protein can be expressed in or targeted into chloroplasts of the plants or be secreted into the extracellular space; in these cases, an N-terminal pre-sequence, such as a plastid transit peptide or a signal sequence for targeting to the extracellular space, is added to the N-terminal or C-terminal end, preferably the C-terminal end, of the antigen as the protein of interest.

In the next step, plant material containing expressed antigen from a plant having expressed the antigen is harvested. Plant material may e.g. be leaves, roots, tubers, or seeds, or a crushed, milled or comminuted product of leaves, roots, tubers, or seeds. The antigen may then be extracted from the plant material using an aqueous buffer. This may include that the plant material is homogenized and insoluble material may be removed by centrifugation or filtration. Soluble components including the antigen will be extracted into the aqueous buffer to produce an antigen solution in the aqueous buffer. The aqueous buffer may contain an inorganic or organic acid or salts thereof and may have a pH as defined below for the aqueous solution as a composition of the invention. Further, the aqueous buffer may contain salt and/or a sulfhydryl compound. The antigen in the obtained antigen preparation may then be further purified using standard methods of protein purification, such as chromatographic methods.

Antigen being VP1 protein or derivative can form VLPs. These VLPs generally form spontaneously in the aqueous buffer used in extraction and purification. Formation of VLPs can be verified e.g. using electron microscopy.

If the immunogenic composition of the invention contains two or more NoV antigens, the two or more antigens may be expressed and purified separately and then mixed desired ratios when preparing the composition. It is also possible to co-express two or more antigens in the same plant cells or plants and purifying the together as a mixture.

Production of B Subunit of an AB₅ Toxin

The B subunit of an AB₅ toxin such as CTB or LTB may be obtained commercially as indicated above. Alternatively, they may be expressed and be purified from different production hosts including mammalian cells, insect cells and plants, similarly as described above for the NoV antigens. Expressed CTB and LTB generally assemble spontaneously to B₅ pentamers. Section “Adjuvant used in the invention” above gives multiple references to AB₅ toxins such as CTB and LTB.

EXAMPLES Example 1

Norovirus VLPs Purification from Plant Material

Norovirus VP1 VLPs have been purified as described below for GII.4 Aomori strain. The five weeks old Nicotiana benthamiana plants were vacuum-infiltrated (80-100 mbar for 3-4 minutes) with diluted Agrobacterum tumefaciens cultures carrying TMV-based assembled magnlCON® vectors (Gleba et al., 2005, Vaccine, 23:17-18; Marillonnet et al., 2005, Nat. Biotechnol., 23:718-723; Gleba et al., Curr. Opin. Biotechnol., 2007, 18:134-141; Klimyuk, V., et al., 2014, Curr. Top. Microbiol. Immunol., 375:127-154) that allows to easily express viral VLPs in Nicotiana benthamiana plants (Zahin, M. et al., 2016, PLoS One, 11(8):e0160995). Plant material was harvested 6-14 days post infiltration. A harvesting time point 7-8 days post infiltration results in the highest expression level for GII.4 strain.

The green biomass was homogenized in the presence of two volumes neutral buffer (i.e. 15 g biomass and 30 mL 100 mM Tris, 5 mM Na₂S20s pH 7.5). For clarification the plant homogenate was centrifuge 20 min. at 15.000×g. The resulting extract was further clarified by filtration using a Millipore® glass fiber filter (AP25).

High molecular weight components were sedimented by ultracentrifugation (150.000×g for 90 min.). The pellet was suspended in 1 mL of 20 mM histidine, 137 mM NaCl pH 6.0 and clarified by 15.000×g centrifugation for 20 minutes. The VLP containing supernatant was placed on the top of a 30% sucrose cushion (in 20 mM histidine, 137 mM NaCl pH 6.5). Ultracentrifugation was performed for 90 min. at 150.000×g. The resulting pellet was resuspended in 20 mM histidine, 137 mM NaCl pH 6.5. VLP formation was confirmed by SEC-HPLC with light scattering analysis.

Example 2 Immunogenicity of Purified VP1 VLPs in Mice Using Intramuscular (IM) Route of Delivery Study Animals

BALB/c Ola/Hsd female mice (Envigo, Netherlands) were shipped at ambient temperature to animal facility. Animals were acclimatized 1-2 weeks prior to immunizations and immunized at 7 weeks of age. Health monitoring data summary form was provided with the shipment of the mice. Animal health (clinical signs of illness) and welfare were monitored daily by the staff of the animal facility. All procedures were authorized and performed according to the guidelines of the Finnish National Animal Experiment Board.

Immunization Procedures

The mice were anesthetized with inhalation of isoflurane (Attane® vet) for the time of immunization and related procedures. Animals were weighted at the beginning of the study and marked with a group tattoo and individually by ear piercing. Fecal samples were collected at the beginning of the study (week (wk) 0) and at the day of termination (wk 5). Tail blood sample (5 mkl volume diluted 1:100 in PBS) was collected at wk 0 and wk 3 prior to immunization. Test article was administered IM in the caudal tight muscle (50 mkl volume) with 0.3 ml insulin syringe (29G×1/2″−0.33×12 mm).

Termination Procedures and Sample Collection

Animal weights were recorded at the time of termination. Fecal samples were collected, pooled and 10% suspensions were prepared before storing at −80° C. until use. The mice were terminated by anesthetizing mice with 1 mg/kg medetomidine (Dorbene® 1 mg/ml, Laboratorios Syva) and 75 mg/kg ketamine (Ketalar® 50 mg/ml, Pfizer) and collecting the terminal whole blood from axillary (armpit) area. Serum was separated of individually collected whole blood samples and stored at −20° C. until used. Spleens were collected and single cell suspensions were prepared. Group-wise pooled cells were aliquoted and stored frozen in liquid nitrogen until used.

We have determined the immunogenicity of the purified, plant-produced form of the norovirus (NoV) GI.4 Chiba and GII.4 Aomori virus-like particles (VLPs) and the effect of Cholera toxin B (CTB, Flarebio Biotech LLC, USA) adjuvant via intramuscular (IM) route. Additionally, as control, the adjuvant effect of aluminum hydroxide [Al(OH)₃, alum] was evaluated. Completely purified recombinant NoV VLPs were administered two times IM to BALB/c mice at weeks 0 and 3 in PBS (pH 7.3). The dose of 1 mkg (microgram or μg) of each Nov VLP was given either alone or combined with 1 mkg of CTB adjuvant, or with 50 mkg alum adjuvant. Mice receiving 1 mkg CTB only were used as negative controls in addition to carrier only (PBS) immunized mice samples of previous study. All mice were terminated at study week 5. Humoral (antibody) immune responses were analyzed by ELISA-based assays and cell-mediated (T cells) immune responses by ELISPOT assays. NoV GI.4 Chiba and GII.4 Aomori VLPs used for immunizations were produced in plants and completely purified at Icon Genetics GmbH laboratory using standard purification technologies. Protein concentration and purity was determined and particles are examined under electron microscopy. VLPs stocks (ca. 1 mg/ml of VLPs in PBS—(10 mM NaH2PO4, 137 mM NaCl pH 6.5) were kept at +4° C. until the use. NoV VLP protein stocks were diluted in PBS pH 7.3 (Lonza BioWhittaker, Cat. BE17-516F) prior to the first immunization at desirable concentration and stored at +4° C. until use.

As a control antigen used in immunological assays, mock preparation magnlCON/N. benthamiana, batch #T1070-pICH56122 SmSc1, with the date of manufacture (DOM) Apr. 20, 2016 was used. NoV GI.1, GI.3, GII.4-1999, GII.4 New Orleans (NO), GII.4 Sydney (SYD), and GII.12 VLPs used to detect NoV specific cross-reactive immune responses were produced in a baculovirus-insect cells expression system by VRC laboratory as previously described (Huhti et al. 2010). GII.17 VLPs used for cross-reactivity analysis were produced in plants and purified by ICON Genetics GmbH.

Adjuvants

Cholera Toxin B (CTB) subunit from recombinant Vibrio cholerae serotype 01 was manufactured by Flarebio (batch #03285; Seq ID No. 83 shown in Table 2) and was provided as a lyophilized protein. Reconstituted by dissolving into 1 mg/ml with sterile Aqua Sterilisata (Fresenius Kabi) according to manufacturer's instructions and stored at −20° C. in aliquots prior to use. This adjuvant is referred to as “rCTB” in these Examples. It was added to vaccine antigen preparations 1 day prior to immunizations and mixtures stored overnight at +4° C.

Aluminum hydroxide gel adjuvant, (Alhydrogel® adjuvant 2%, InvivoGen, #vac-alu-250) was provided as a ready-to-use gel suspension. Alum was added to vaccine antigen preparations 1 day prior to immunizations and mixtures stored overnight at +4° C.

Study Assays Humoral Immune Response Assays

Titers of antigen-specific (Nov GI.4 Chiba, GII.4 Aomori) IgG, IgG1 and IgG2a in serum were tested by enzyme-linked immunosorbent assay (ELISA) as previously described (Blazevic et al., 2011, Vaccine, 29:81268133; Tamminen et al., 2012, Immunology, 135:89-99). The serum IgG mock responses (antimagnlCON/N. benthamiana) were tested by ELISA at 1:200 dilution.

Kinetics were analyzed from tail blood samples collected from individual mice at week (wk) 0 and 3. The cross-reactivity of serum IgG antibodies to NoV VLP genotypes not included in the administered antigen preparation was determined by ELISA. Pooled fecal suspensions were analysed for homotypic NoV IgG antibodies.

Pig gastric mucin (PGM)-based homologous blocking assay (Lindesmith et al., 2012, J. Virol., 86:873-883) and human type A saliva-based cross-blocking assay was used to determine the ability of immune sera to block the binding of NoV VLPs to the putative NoV receptors, human histo-blood group antigens (HBGA) as previously described (Uusi-Kerttula et al., 2014, Microbes Infect., 16:472-480).

The results of experiments for immune responses against IM delivered GI.4 and GII.4 antigens are shown in the FIGS. 1 and 2 , respectively. In both figures, upper panel shows serum IgG titers; middle panel shows kinetics of norovirus-specific IgG immune responses developed in pooled sera and lower panel shows blocking efficiency of NoV-specific sera. For more details, reference is made to the figures legends.

Example 3 Immunogenicity of Purified VP1 VLPs in Mice Using Intradermal (ID) Route of Delivery

The mice, antigens formulations and measurements for testing immunogenicity of intradermally delivered vaccine were prepared and carried out as described in Example 2. The results of experiments for immune responses against ID delivered GI.4 and GII.4 antigens are shown in the FIGS. 3 and 4 , respectively. In both figures, the upper panel shows serum IgG titers; the middle panel shows kinetics of norovirus-specific IgG immune responses developed in pooled sera and lower panel shows blocking efficiency of NoV-specific sera. For more details, reference is made to the figures legends.

Example 4 Immunogenicity of Purified VP1 VLPs in Mice Using Intranasal (IN) Route of Delivery

The mice, antigens formulations and measurements for testing immunogenicity of intranasally delivered vaccine were prepared and carried out as described in Example 2. The results of experiments for immune responses against IN delivered GI.4 and GII.4 antigens are shown in the FIGS. 5 and 6 , correspondingly. In both figures upper panel shows serum IgG titers; middle panel shows kinetics of norovirus-specific IgG immune responses developed in pooled sera and lower panel shows blocking efficiency of NoV-specific sera. For more details, reference is made to the figures legends.

Example 5 Immunogenicity of Purified VP1 VLPs in Mice Using Subcutaneous (SC) Route of Delivery

The mice, antigens formulations and measurements for testing immunogenicity of subcutaneously delivered vaccine were prepared and carried out as described in Example 2. The results of experiments for immune responses against SC delivered GI.4 and GII.4 antigens are shown in the FIG. 9 . For more details, reference is made to the figure legend.

Example 6

Production of recombinant exotoxin B subunits in plants B subunits of bacterial type I exotoxins (Cholera toxin and E. coli heat-labile toxin) have been purified as described below. Five weeks old Nicotiana benthamiana plants were vacuum-infiltrated (80-100 mbar for 3-4 minutes) with diluted Agrobacterium tumefaciens cultures carrying TMV-based assembled magnlCON® vectors (Gleba et al., 2005, Vaccine, 23:17-18; Marillonnet et al., 2005, Nat. Biotechnol., 23:718-723; Gleba et al., Curr. Opin. Biotechnol., 2007, 18:134-141; Klimyuk, V., et al., 2014, Curr. Top. Microbiol. Immunol., 375:127-154) which allow easy expression of B subunits of bacterial type I exotoxins in Nicotiana benthamiana plants (Hamorsky et al., 2013, PLoS Negl Trop Dis. 7(3):e2046; Hamorsky et al., 2015, Sci Rep. 5:8003). Plant material was harvested 6-14 days post infiltration. The green biomass was homogenized in the presence of two volumes neutral buffer (i.e. 15 g biomass and 30 mL 100 mM Tris, 60 mM Ascorbic acid, 0.5M NaCl pH 7.5). For clarification the plant homogenate was centrifuge 20 min. at 15.000×g. The resulting extract was further clarified by filtration using a Millipore® glass fiber filter (AP25). The recombinant exotoxin B subunits were purified by affinity chromatography on a lyso-GM1 ganglioside-Spherosil® column using the procedure described by J. L. Tayot et al, 1981, Eur J Biochem 113:249-258. Formation of subunit B pentamers was confirmed by size exclusion chromatography.

Example 7 Use of Recombinant Exotoxin B Subunits in Vaccine Formulations

CTB or LTB of any origin, preferably recombinant CTB or LTB produced in plants, can be used for the immunogenic and vaccine formulation of the invention. Depending on the dose of exotoxin B subunit and norovirus VLPs, LTB or CTB fulfill the function of an adjuvant (please refer to FIGS. 7-8 ), but also show antigenic properties by causing immune response to itself (see FIG. 12 , right panel).

TABLE 1A Norovirus capsid protein sequences cloned in this invention. GenBank UniProt Vector No . Genotype Strain acc. acc. designation  1 GI.1 Aichi/124-89/JP BAA83413 Q9QT39 pICH99711  2 GI.2 Funabashi258/96/JP BAC05516 Q8JW44 pICH99723  3 GI.3 Shimizu/KK2866/JP AII73765 A0A076JEQ3 pICH99735  4 GI.4 Chiba407/87/JP BAA82106 Q9QTE7 pICH96101  5 GI.6 WUG1/00/JP BAC11840 Q8JVV5 pICH99744  6 GI.7 TCH-060/USA/2003 AEQ77282 G8FL04 pICH99758  7 GII.1 Noda485/00/JP AAZ66776 Q20K66 pICH99766  8 GII.2 MK04/2004/JP ABE41641 A4K7J2 pICH99770  9 GII.2 Ina NG1/JP/2002 BAD72797 Q5TKU0 pICK00111 10 GII.2 OC08154/JP/2008 BAL60769 H3JZF7 pICK00123 11 GII.3 SaitamaU201/98/JP BAB84155 Q8V768 pICH96113 12 GII.3 Texas/TCH04- BAG30939 B2DD27 pICH99781 577/2004/US 13 GII.3 Kashiwa336/00/JP AAZ66774 Q20K68 pICH99798 14 GII.3 HKG/2014/CUHK-NS-232 AHZ12739 A0A024B5V5 pICH99803 15 GII.4 Aomori2/2006/JP BAG70446 B5BTJ5 pICH96125 16 GII.4 Sydney/NSW0514/2012/ AFV08795 K4LM89 pICH96137 AU 17 GII.4 NIHIC35/2013/USA AGX85919 U5N472 pICH99812 18 GII.4 NL/2014/GII.4/Groningen CRL46961 A0A0G4PZF4 pICH99829 01 19 GII.4 Sequence 1 from US n.a. n.a. pICK02813 2016 0168543 20 GII.6 Ueno7k/94/JP BAC05518 Q8JW42 pICH99834 21 GII.6 Sanbu445/00/JP AAZ66775 Q20K67 pICH99848 22 GII.7 Osaka10-25/99/JP BD011881 n.a. pICH99850 23 GII.13 Kashiwa47/97/JP BAC05515 Q8JW45 pICH99861 24 GII.14 JP/2007/Fukuoka/KK282 AII73780 A0A076JER8 pICH99872 25 GII.17 C142/1978/GUF AGI17592 M4WL70 pICH99887 26 GII.17 JP/2013//Saitama5203 BAR63715 A0A0E3VY34 pICH99890 27 GII.17 JP/2015/Kawasaki308 BAR42289 A0A0E4B1P1 pICH99909 28 GII.17 JP/2002/Saitama/T87 AII73747 A0A076JB57 pICH99912 29 GIV.1 Ahrenshoop246/DEU/2012 AFN61315 I6Y0E0 pICH99924

TABLE 1B Norovirus capsid proteins with SEQ ID NQs and amino acid sequences. magniCQN ® magniCQN ® VLP SEQ ID Geno- GenBank vector expression formation No. type Strain acc. Amino Acid Sequence designation confirmed confirmed*  1 GI HuzhouN11/ AGJ52175 MMASKDAPTSPDGASGAGQLVPEANTAEQISMDPVAGASTAVATAG n.a. n.a. n.a. 2008/ QVNMIDPWIFNNFVQAPQGEFTISPNNTPGDILFDLQLGPHLNPFL CHN AHLSQMYNGWVGNMRVRILLAGNAFTAGKIIICCVPPGFDARILTI AQATLFPHLIADVRTLEPVELPLEDVRNVLYHNSSQPQPTMRLVAM LYTPLRTGGGSGGTDAFVVAGRVLTCPAPDFSFLFLVPPSVEQKTR VESVPNIPLKDLSNSRVPVPIQGMFMSPDVNQSVQFQNGRCQIDGQ LQGTTPVSLSQLCKIRGKTSSNARVLNLSEVDGTPFIPLESPAPVG FPDLGGCDWHVNFSFQTQDRDPSQSVTFATNDASFVPYLGSVSPHN GEGFQAGDIIGSLGWISAPSDNSQFNVWAIPKYGSSLQMSPILLLL CSPRLWEVILYFYSTFPGSGQPSQLQVPCLLPQEFITHFCNEQAPI AGEAALLHYVDPDTGRNLGEFKLYPDGFMTCVPNSVSSGPQTLPIN GVFVFVSWVSRFYQLKPVGTASAARRLGLRRI  2 GI ETH/ AUF81820 MMMASKDAPTNMDGTSGAGQLVPEANTAEPISMEPVAGAATAAATA n.a. n.a. n.a. 2016/P15 GQVNMIDPWIMNNYVQAPQGEFTISPNNTPGDILFDLQLGPHLNPF LSHLAQMYNGWVGNMKVKVLLAGNAFTAGKIIISCIPPGFAAQNIS IAQATMFPHVIADVRVLEPIEIPLEDVRNVLFHNNDNTPTMRLVCM LYTPLRASGSSSGTDPFVIAGRVLTCPSPDFSFLFLVPPNVEQKTK PESVPNLPLNILSSSRVPSLIKSMMISRDHGQMVQFQNGRVTLDGQ LQGTTPTSASQLCKIRGSVFHANGGNGYNLTELDGSPYHAFESPAP IGEPDLGECDWHMEASPTIQFDTGDVIKQINVKQESAFAPHLGTVQ ADGLDGVSANTNMIAKLGWVSPVSDGHRRDVDPWVIPRYGSTLTEA AQLAPPIYPPGFGEAIVFFMSDFPIAHGTNGLSVPCTIPQEFVTHE VNEQAPTRGEAALLHYLDPDTHRNLGEFKLYPDGFMTCVPNSSGSG PQTLPINGVEVEVSWVSRFYQLKPVGTAGPARRLGIRRS  3 GI E8/UG/ AFN0673 MMMASKDAPTNMDGTSGAGQLVPEANTAEPISMDPVAGAATAVATA n.a. n.a. n.a. 1976 GQINMIDPWIMSNEVQAPQGEFTVSPNNTPGDVLFDLQLGPQLNPF LAHLAQMYNGWVGNMRVKVLLAGNAFTAGKIIISCIPPGFTSQNIS IAQMTMFPHVIADVRVLEPIEIPLEDVRNVLFHTNDNRPTMRLVCM LYTPLRANGSSSGTDPFVIAGRVLTCPDSNFSFLFLVPPNVEQKTR PFSVPNIPLNTLSNSRVPSLIKSMTISRDQNQIIQFQNGRVTLDGQ LQGTTPTSVSQLCKIRGTTYHATGGNGINLTELNGEPYHAFESPAP IGFPDLGGCDWHLTATPTQAFNDGAKVVRLSVTQGAAFAPHLGTIH YTTTDHDYDPNTSIICTLDWLSQTTGQNNVDPWQIPTYGSTLTEAA QLAPPIFPPGFGETLVFFLSDFPISNGKNGLSVPCTLPQEFVTHFV NEQAPIRGEAALLHYVDPDTHRNLGEFKLYPEGEMTCVPNTSGGGP QTLPINGVFVFVSWVSRFYQLKPVGTAGAARRLGIRRS  4 GI 46-2/ BAV21674 MASKDAPSNMDGTSGAGQLVPEANTAEPINMESVVGAATATATAGQ n.a. n.a. n.a. Tokyo/ VNLIDPWIMNNYVQAPQGEFTISPNNTPGDVLFDLQLGPHLNPFLS 1977/JPN HLSRMYNGWVGNMKVRVMLAGNAFSAGKIIICCIPPGFTSQSISIA QATMFPHVIADVRVLEPIDVPLDDVRNVLFHNNDNAQTMRLLCMLY TPLRTGASSSGSDPFVIAGRVLTCPTQDFNFLFLVPPDVEQKTKPF SVPNIPLNLMSNSRVPALIDGMTVSSDQNQVVQFQNGRVTLDGQLQ GTTAVSASCVAKIRGRIFSNASHYGINLTEVDGTQYHAFDSPAPLG FPDFGNCDWHVTGTKASQGDLQTDNPTISGTIKSYESSFAPHLGTV RIEGDDNELARFNGKDVLLNLTWFSQRNGSQLNLWTIPSYGSNLTE ASQLAPPIYPPGFGEAIVYFTSTFPAISRPSVPCTMPQEFVSHEVN EQAPTRGEAALLHYLDPDTHRNLGEFKMYPEGFFTCVPNAGGSGPQ TLPINGVEVFVSWVSRYYQLKPVGTVGMTRRLGLMKQ  5 GI.1 Aichi/124- BAA83413 MMMASKDATSSVDGASGAGQLVPEVNASDPLAMDEVAGSSTAVATA pICH99711 Yes n.t. 89/JP GQVNPIDPWIINNEVQAPQGEFTISPNNTPGGVLFDLSLGPHLNPF LLHLSQMYNGWVGNMRVRIMLAGNAFTAGKIIVSCIPPGFGSHNLT IAQATLFPHVIADVRTLDPIEVPLEDVRNVLFHNNDRNQQTMRLVC MLYTPLRTGGGTGDSFVVAGRVMTCPSPDFNFLFLVPPTVEQKTRP FTLPNLPLSSLSNSRAPLPISGMGISPDNVQSVQFQNGRCTLDGRL VGTTPVSLSHVAKIRGTSNGTVINLTELDGTPFHPFEGPAPIGFPD LGGCDWHINMTQFGHSSQTQYDVDTTPDTEVPHLGSIQANGIGSGN YIGVLSWVSPPSHPSGSQVDLWKIPNYGSSITEATHLAPSVYPPGE GEVLVFFMSKIPGPGAYSLPCLLPQEYISHLASEQAPTVGEAALLH YVDPDTGRTLGEFKAYPDGFLTCVPNGASSGPQQLPINGVFVEVSW VSRFYQLKPVGTASSARGRLGLRR  6 GI.1 United NP_056821 MMMASKDATSSVDGASGAGQLVPEVNASDPLAMDEVAGSSTAVATA n.a. n.a. n.a. States/ GQVNPIDPWIINNEVQAPQGEFTISPNNTPGDVLFDLSLGPHLNPF Norwalk/ LLHLSQMYNGWVGNMRVRIMLAGNAFTAGKIIVSCIPBGFGSHNLT 1968 IAQATLFPHVIADVRTLDPIEVPLEDVRNVLFHNNDRNQQTMRLVC MLYTPLRTGGGTGDSFVVAGRVMTCPSPDFNFLFLVPPTVEQKTRP FTLPNLPLSSLSNSRAPLPISSMGISPDNVQSVQFQNGRCTLDGRL VGTTPVSLSHVAKIRGTSNGTVINLTELDGTPFHPFEGPAPIGFPD LGGCDWHINMTQFGHSSQTQYDVDTTPDTFVPHLGSIçANGIGSGN YVGVLSWISPPSHPSGSQVDLWKIPNYGSSITEATHLAPSVYPPGF GEVLVFFMSKMPGPGAYNLPCLLPQEYISHLASEQAPTVGEAALLH YVDPDTGRNLGEFKAYPDGFLTCVPNGASSGPQQLPINGVFVFVSW VSRFYQLKPVGTASSARGRLGLRR  7 GI.2 Funabashi258/ BAC05516 MMMASKDAPQSADGASGAGQLVPEVNTADPLPMEPVAGPTTAVATA pICH99723 Yes n.t. 96/JP GQVNMIDPWIVNNEVQSPQGEFTISPNNTPGDILFDLQLGPHLNPF LSHLSQMYNGWVGNMRVRILLAGNAFSAGKLIVCCVPPGFTSSSLT IAQATLFPHVIADVRTLEPIEMPLEDVRNVLYHTNDNQPTMRLVCM LYTPLRTGGGSGNSDSFVVAGRVLTAPSSDFSFLFLVPPTIEQKTR AFTVPNIPLQTLSNSRFPSLIQGMILSPDASQVVQFQNGRCLIDGQ LLGTTPATSGQLFRVRGKINQGARTENLTEVDGKPFMAFDSPAPVG FPDFGKCDWHMRISKTPNNTSSGDPMRSVSVQTNVQGFVPHLGSIQ FDEVENHPTGDYIGTIEWISQPSTPPGTDINLWEIPDYGSSLSQAA NLAPPVFPPGFGEALVYFVSAFPGPNNRSAPNDVPCLLPQEYITHE VSEQAPTMGDAALLHYVDPDTNRNLGEFKLYPGGYLTCVPNGVGAG PQQLPLNGVFLFVSWVSRFYQLKPVGTASTARSRLGVRRI  8 GL.2 Kaohsiung/ ARC53064 MMMASKDAPQSADGASGAGQLVPEVNTADPLPMEPVAGPTTAVATA n.a. n.a. n.a. 16-AF-2/ GQVNMIDPWIVNNEVQSPQGEFTISPNNTPGDILFDLQLGPHLNPF 2016/TW LSHLSQMYNGWVGNMRVRILLAGNAFSAGKIIVCCVPPGFTSSSLT IAQATLFPHVIADVRTLEPIEMPLEDVRNVLYHTNDNQPTMRLVCM LYTPLRTGGGSGSSDSFVVAGRVLTAPSSDFSFLFLVPPTIEQKTR AFTVPNIPLQTLSNSRFPSLIQGMILSPDASQVVQFQNGRCLIDGQ LLGTTPATSGQLFRVRGKINQGARTLNLTEVDGKPFMAFDSPAPVG FPDFGKCDWHMRISKTPNNTSSGDPMRSVSVQTNVQGEVPHLGSIQ FDEVENHPTGDYIGTIEWISQPSTPPGTDINLWEIPDYGSSLSQAA NLAPPVFPPGFGEALVYFVSAFPGPNNRSAPNDVPCLLPQEYITHE VSEQAPTMGDAALLHYVDPDTNRNLGEFKLYPGGYLTCVPNGVGAG PQQLPLNGVFLFVSWVSREYQLKPVGTASTARGRLGVRRI  9 GI.3 Shimizu/ A1173765 MMMASKDAPTNMDGTSGAGQLVPEANTAEPISMEPVAGAATAAATA pICH99735 Yes n.t. KK2866/JP GQVNMIDPWIMNNYVQAPQGEFTISPNNTPGDILFDLQLGPHLNPF LSHLAQMYNGWVGNMKVKVLLAGNAFTAGKIIISCIPPGEVAQNVS IAQATMEPHVIADVRVLEPIEVPLEDVRNVLFHNNDNTPTMRLVCM LYTPLRASGSSSGTDPFVIAGRVLTCPSPDFSFLFLVPPNVEQKTK PFSVPNLPLNTLSNSRVPSLIKSMMVSRDHGQMVQFQNGRVTLDGQ LQGTTPTSASQLCKIRGSVFHANGGNGYNLTELDGSPYHAFESPAP IGFPDLGECDWHMEASPTTQFNTGDVIKQINVKQESAFAPHLGTIQ ADGLSDVSVNTNMIAKLGWVSPVSDGHKGDVDPWVIPRYGSTLTEA AQLAPPIYPPGFGEAIVFFMSDFPIAHGTNGLSVPCTIPQEFVTHE VNEQAPTRGEAALLHYLDPDTHRNLGEFKLYPDGFMTCVPNSSGTG PQTLPINGVFVFVSWVSRFYQLKPVGTAGPARRLGIRRS 10 GI.3 0304-19. ARI71147 MMMASKDAPTNMDGTSGAGQLVPEANTAEPISMEPVAGAATAAATA n.a. n.a. n.a. GQVNMIDPWIMNNYVQAPQGEFTISPNNTPGDILFDLQLGPHLNPF LSHLAQMYNGWVGNMKVKVLLAGNAFTAGKIIISCIPPGFAAQNIS IAQATMEPHVIADVRVLEPIEVPLEDVRNVLFHNNDNTPTMRLVCM LYTPLRASGSSSGTDPFVIAGRVLTCPSPDFSFLFLVPPNVEQKTK PFSVPNLPLNTLSNSRVPSLIKSMMVSRDHGQMVQFQNGRVTLDGQ LQGTTPTSASQLCKIRGSVFHANGGNGYNLTELDGSPYHAFESPAP IGFPDLGECDWHMEASPTTQFNTGDVIKQINVKQESAFAPHLGTIQ ADGLSDVSVNTNMIAKLGWVSPVSDGHKRDVDPWVIPRYGSTLTEA AQLAPPIYPPGFGEAIVFEMSDFPIAHGTNGLSVPCTIPQEFVTHE VNEQAPTRGEAALLHYLDPDTHRNLGEFKLYPDGFMTCVPNSSGTG PQTLPINGVEVFVSWVSRFYQLKPVGTAGPARRLGIRRS 11 GI.3 B8/CF/ AFN06739 MMMASKDAPTNMDGTSGAGQLVPEANTAEPISMEPVAGAATAAATA n.a. n.a. n.a. 1977 GQVNMIDPWIMNNYVQAPQGEFTISPNNTPGDILFDLQLGPHLNPF LSHLAQMYNGWVGNMKVKVLLAGNAFTAGKIIISCIPPGFASQNIS IAQATMEPHVIADVRVLEPIEVPLEDVRNVLFHNNDNTPTMRLVCM LYTPLRASGSSSGTDPFVIAGRVLTCPSPDFSFLFLVPPNVEQKTK PFSVPNLPLNVLSNSRVPSLIKSMMVSQDHGQMVQFQNGRVTLDGQ LQGTTPTSASQLCKMRGTVYHASGGQGLNLTEIDGTPYHAFESPAP IGFPDIGDSDWHINASPATTFDSGESIKRLDMEQGSSFAPHLGTVH YTNADYPANTDLICSLEWLSPPSGGTPNKVNPWTIPRYGSTLTEAA QLAPPIYPPGFGEAIVFFMSDFPIANGQDGLKVPCTIPQEFVTHFV NEQAPTRGEAALLHYVDPDTHRNLGEFKLYPEGEMTCVPNSSGSGP QTLPINGVFTFVSWVSRFYQLKPVGTTGPVRRLGIRRS 12 GI.3 15-EN- AQQ95034 MMMASKDAPTNMDGTSGAGQLVPEANTAEPISMEPVAGAATAAATA n.a. n.a. n.a. 3/2015 GQVNMIDPWIMNNYVQAPQGEFTISPNNTPGDILFDLQLGPHLNPF LSHLAQMYNGWVGNMKVKVLLAGNAFTAGKIIISCIPPGFASQNIS IAQATMEPHVIADVRVLEPIEVPLEDVRNVLFHNNDNSPTMRLVCM LYTPLRASGSSSGTDPFVIAGRVLTCPSPDFSFLFLVPPNVEQKTK PFSVPNLPLNTLSNSRVPSLINAMMISRDHGQMVQFQNGRVTLDGQ LQGTTPTSLSQLCKIRGKVFLASGGNGLNLTELDGSAYHAFESPAP IGFPDIGDCDWHMNATATSNFTGSNDEHQILVKQESTFAPHLGHVQ ADHLPEVANTDLMVSLSWISPVSDQHRRDVDPWVIPRYGSTLTEAA QLAPPIYPPGFGEAIVFFMSDFPVVSGVNGMRIPCTLPQEYVAHEV NEQAPTRGEAALLHYVDPDTHRNLGEFKIYPEGEMTCVPNSSGTGP QTLPINGVFTFVSWVSRFYQLKPVGTAGPARRLGIRRS 13 GI.4 Chiba407/ BAA82106 MMMASKDATPSADGATGAGQLVPEVNTADPIPIDEVAGSSTALATA pICH96101 Yes Yes 87/JP GQVNLIDPWIINNEVQAPQGEFTISPNNTPGDVLFDLQLGPHLNPF LSHLSQMYNGWVGNMRVRVVLAGNAFTAGKVIICCVPPGFQSRTLS IAQATLFPHVIADVRTLDPVEVPLEDVRNVLYHNNDTQPTMRLLCM LYTPLRTGGASGGTDSFVVAGRVLTCPGPDFNFLFLVPPTVEQKTR PFTVPNIPLKYLSNSRIPNPIEGMSLSPDQTQNVQFQNGRCTIDGQ PLGTTPVSVSQLCKFRGRITSGQRVLNLTELDGSPFMGFGAPAPAG FPDLGSCDWHIEMSKIPNSSTQNNPIVTNSVKPNSQQFVPHLSSIT LDENVSSGGDYIGTIQWTSPPSDSGGANTNEWKIPDYGSSLAEASQ LAPAVYPPGENEVIVYFMASIPGPNQSGSPNLVPCLLPQEYITHFI SEQAPIQGEAALLHYVDPDTNRNLGEFKLYPGGYLTCVPNSSSTGP QQLPLDGVFVFASWVSRFYQLKPVGTAGPARGRLGVRR 14 GI.4 S14/2008/ AEY77031 MMMASKDATPSADGATGAGQLVPEVNTADPIPIDPVAGSSTALATA n.a. n.a. n.a. LillaEdet/ GQVNLIDPWIINNEVQAPQGEFTISPNNTPGDVLFDLQLGPHLNPF Sweden LSHLSQMYNGWVGNMRVRVVLAGNAFTAGKVIICCVPPGFQSRTLS IAQATLFPHVIADVRTLDPVEVPLEDVRNVLYHNNDTQPTMRLLCM LYTPLRTGGASGGTDSFVVAGRVLTCPGPDFNFLFLVPPTVEQKTR PFTVPNIPLKYLSNSRIPNPIEGMSLSPDQTQNVQFQNGRCTIDGQ PLGTTPVSVSQLCKERGRITSGQRVLNLTELDGSPFMAFAAPAPAG FPDLGSCDWHIEMSKIPNSSTQNNPIVVNSVKPNSQQEVPHLSSIT LDDNVSSGGDYIGTIQWTSPPSDSGGANTNFWKIPDYGSSLAEASQ LAPAVYPPGFNEVIVYFMASIPGPNQSGSPNLVPCLLPQEYITHFI SEQAPIQGEAALLHYVDPDTNRNLGEFKLYPGGYLTCVPNSSSTGP QQLPLDGVEVFASWVSRFYQLKPVGTA 15 GI.5 15-EN- AQQ95019 MMMASKDATPSADGANGAGQLVPEVNNAEFLPLDPVAGASTALATA n.a. n.a. n.a. 8/2015 GQVNMIDPWIENNEVQAPQGEFTISPNNTPGDILFDLQLGPHLNPE LAHLSQMYNGWVGNMRVRVILAGNAFTAGKVIICCVPPGFQSRTLS IAQATLFPHIIADVRTLEPIEIPLEDVRNTLYHTNDNQPTMRLLCM LYTPLRTGGGSGGTDAFVVAGRVLTSPSPDFNFLFLVPPTVEQKTR PFSVPNIPLQLLSNSRVPNLIQSMVPSPDQAQNVQFQNGRCTTDGQ LLGTTPVSVSQILKFRGKVSAGSKVINLTELDGSPFLAFEAPAPTG FPDLGTSDWHIEMSLNSNSQSSGNPILLRDIQPNSSDEVPHLGSVA VTTAIDTAGDYTGTIQWTSQPSNVTPVPDVNEWTIPQYGSNLAEAS QLAPVVYPPGFGEAIVYFMSPIPGPNTAHKPNLVPCLLPQEFVTHE VSEQAPSMGEAALVHYVDPDTNRNLGEFKLYPEGFITCVPNGTGPQ QLPLNGVFVFASWVSRFYQLKPVGTANSARGRLGVRR 16 GL.5 Jp/2002/ BAU16307 MMMASKDATPSADGANGAGQLVPEVNNAEPLPLDPVAGASTALATA n.a. n.a. n.a. QC020180 GQVNMIDPWIENNEVQAPQGEFTISPNNTPGDILFDLQLGPHLNPF LAHLSQMYNGWVGNMRVRVILAGNAFTAGKVIICCVPPGFQSRTLS IAQATLFPHVIADVRTLEPLEIPLEDVRNTLYHNNDSQPTMRLLCM LYTPLRTGGGSGGTDAFVVAGRVLTCPSPDFNFLFLVPPTVEQKTR PFSVPNIPLQNLSNSRVPSLIQSMVLSSDHAQTVQFQNGRCTTDGH LLGTTEVSSGQLMKFRGKVTPGSKVLNLTELDGSPFLAFEPPAPAG FPDLGKCDWHIEMSLYQVNNQDNPIVLRAIEPNSSSFVPHLGSVSF NQNVDAAGDYVCTIQYTSPPSNSHDADVDEWSIPDYGSNLAEASQL APVVYPPGFGEAIVYFMSRVPGWNRTNRLNLVPCLLPQEFIGHEVS EQAPAIGEAALLHYVDPDTNRNLGEFKLYPEGFITCVPNGTGPQQL PLNGVEVFSSWVSRFYQLKPVGTASSARGRLGIRR 17 GI.6 6WUG1/ BAC11840 MMMASKDAPTSPDGASGAGQLVPEANTAEQISMDPVAGASTAVATA pICH99744 Yes n.t. 00/JP GQVNMIDPWIENNEVQAPQGEFTISPNNTPGDILFDLQLGPHLNPE LAHLSQMYNGWVGNMRVRILLAGNAFTAGKIIICCVPPGEDARILT IAQATLFPHLIADVRTLEPVELPLEDVRNVLYHNSSQPQPTMRLVA MLYTPLRTGGGSGGTDAFVVAGRVLTCPAPDFSFLFLVPPSVEQKT RVFSVPNIPLKDLSNSRVPVPIQGMFMSPDVNQSVQFQNGRCQIDG QLQGTTPVSLSQLCKIRGKTSSNARVLNLSEVDGTPFIPLESPAPV GFPDLGGCDWHVNFTFQAQNQDPSQSVTFATNDASEVPYLGSISPH NGGDFHAGDIIGSLGWISAPSDNTQLNVWTIPKYGSSLQMSLTLHL LCSPRLWEVILYFYSTFPGSGQPSQLQVPCLLPQEFITHFCNEQAP IAGEAALLHYVDPDTGRNLGEFKLYPDGFMTCVPNSVSSGPQTLPI NGVFVFVSWVSRFYQLKPVGTASAARRLGLRRI 18 GI.6 Jp/2013/ BAU16303 MMMASKDVPTSPDGASGAGQLVPEVNTADQISMDPVAGASTAVATA n.a. n.a. n.a. s130147 GQVNMIDPWIFNNFVQAPQGEFTISPNNTPGDILFDLQLGPHLNPF LAHLSQMYNGWVGNMRVRILLAGNAFTAGKIIICCVPPGFDARILT IAQATLFPHLIADVRTLEPVELPLEDVRNVLYHNSSQPQPTMRLVA MLYTPLRTGGGSGGTDAFVVAGRVLTCPAPDFSFLFLVPPSVEQKT RVFSVPNIPLKDLSNSRVPTLIQGMFVSPDVNQSVQFQNGRCQIDG QLQGTTPVSLSQLCKIRGKTSSNTRVLNLSEVDGTPFVPLESPAPV GFPDIGGCDWHVGFTFEARDQGPSQNVTFATNDSSFVPYLGSISPH NGDGFHSGDIIGSLDWISAPSDGSALDVWSIPKYGSSLPDVTHLAP AVFPPGFGEVILYFHSKFPGSGPTDKLRVPCLMPQEFITHFCDEQA PIAGEAALLHYVDPDAGRNLGEFKLYPDGFMTCVPNSISSGPQTLP INGVEVFVSWVSRFYQLKPVGTASMARRLGLRRI 19 GI.7 TCH- AEQ77282 MMMASKDAPSNMDGTSGAGQLVPEVNAAEPLPLEPVVGAATAAATA pICH99758 Yes n.t. 060/USA/ GQVNLIDPWIMNNEVQAPEGEFTISPNNTPGDILFDLHLGPHLNPE 2003 LQHLSQMYNGWVGNMRVRVMLAGNAFTAGKIIICCVPPGFASQNIS IGQATMEPHVIADVRVLEPIEIPLDDVRNVLFHTNENRPTMRLLCM LYTPLRAGGASSGTDPFVIAGRVLTCPSPDFNFLFLVPPSVEQKTR QLTVPNIPLNNLANSRVPAMINKMTVSTDQNQVVQFQNGRCTLEGQ LLGTTPVSASQVARIRGKVFSTASGKGLNLTELDGTPYHAFESPAP LGFPDIGACDWHVSTFKVDQNLSGDPMSRLDVKQNAPFAPHLGSIE FTSDQDPTGDQLGTLAWVSPSTSGARVDPWKIPSYGSTVTESTHLA PPIFPPGFGEAIVYFMSDFPIVSGNTAQVPCTLPQEFVSHFVEQQA PVRGEAALLHYVDPDTHRNLGEFKLYPDGFITCVPNTGGGPQNLPT NGVFVFSSWVSRYYQLKPVGTAGPARRLGVRRV 20 GI.7 USA/2011/ APA31976 MMMASKDAPSNMDGTSGAGQLVPEVNAAEPLPLEPVVGAATAVATA n.a. n.a. n.a. GI.P7_ GQVNLIDPWIMNNEVQAPEGEFTISPNNTPGDILFDLQLGPHLNPF GI.7/CS5567 LQHLSQMYNGWVGNMRVRVMLAGNAFTAGKIIICCVPPGFASQNIS IGQATMEPHVIADVRVLEPIEIPLDDVRNVLFHTNESRPTMRLLCM LYTPLRAGGASSGTDPFVIAGRVLTCPSPDFNFLFLVPPSVEQKTR QLTVPNIPLNNLANSRVPAMINKMTVSTDQSQVVQFQNGRCTLEGQ LLGTTPVSASQVARIRGKVESTASGKGLNLTELDGTPYHAFESPAP LGFPDIGACDWHVSTFKVDQNLSGDPMSRLDIKQNAPFAPHLGSIE FTSDQEPTGDQLGTLAWVSPSTSGARVDPWKIPSYGSTVTESTHLA PPIFPPGFGEAIVYFMSDFPIVSGNTAQVPCTLPQEFVSHFVEQQA PIRGEAALLHYVDPDTHRNLGEFKLYPDGFITCVPNTGGGPQNLPI NGVEVESSWVSRYYQLKPVGTAGPARRLGVRRV 21 GI.8 CHN/2008/ AKM20815 MMMASKDAPTNMDGTSGAGQLVPEANTAEPLPIKPVAGAATAVATA n.a. n.a. n.a. GI. GQVNMIDPWIMNNEVQAPQGEFTISPNNTPGDILFDLQLGPHLNPE P8_G1.8/ LAHLSRMYNGWVGNMQVRIMLAGNAFSAGKIIVCCIPPGFSSQSIS Huzhou/N10 IAQATMFPHVIADVRVLEPIDVPLDDVRNVLFHNNDNPQTMRLLCM LYTPLRSGGTSSGTDPFVIAGRVLTCPTPDFSFLFLVPPDIEQRTK PFSVPNIPMNLMSNSRVSMLIDGMMVSNDQNQVPQFQNGRVTLDGQ LQGTTTVSAACVARMRGRIFNNNGNYGVNLTELDGNPYHAFDSPAP LGFPDFGNCDLHMTFVKINPNELSSGDPSGKVVIRSYDATFAPHLG TVKLENDDELARFVGKEVVLELTWVSNREGATLNLWAVPNYGSSLT QASQLAPPIYPPGFGEAIVYFTSTFPTVSNPKVPCTLPQEFVSHFV NEQAPTRGDAALLHYVDPDTHRNLGEFKMYPEGYMTCVPNAGGGPQ TLPINGVFVFISWVSRYYQLKPVGTAGAARRLGLRRS 22 GI.9 USA/2016/ APA31982 MMMASKDATSNMDGTSGAGQLVPENNNTSEPINMEPVAGAVTAAAT n.a. n.a. n.a. GI.P9_ AGQVNMIDPWIMNNYVQAPQGEFTISPNNTPGDILFDLQLGPHLNP GI.9/ FLAHLSQMYNGWVGNMKVRVVLAGNAFSAGKIIVCCIPPGFSAPNI SC6350 SIAQATMEPHVIADVRVLEPIDIPLDDVRNVLFHNNDNGNQTMRLL CMLYTPLRSGGTSSGTDPFVIAGRVLTCPTPDFNFLFLVPPTVEQK TKQFSVPNLPLNVMSNSRVPSLLNAMVVSPDQAQVVQFQNGRCTLD GQMLGTTTVSASCVARFRGKTFQAPDNRLGINLAEISGEPYHAFES PAPLGFPDFGDGDWHVTATKVTPSQLEANDPVVMGNVQPYNPQFAP HLGTLVVENPTPDNVTTGTDLLFNITWLSNRANNRENPWVIPNYGS TLTEAAQLAPSIFPPGFGETIVYENSTFPAVGATTHAAIPCLLPQE FVAHFVNEQAPIRGEAALLHYIDPDTHRNLGEFKIYPEGFVTCVPN VGGTGPQSLPTNGIFVFVSWVSRYYQLKPVGTAGQARRLGFRRV 23 GII PE/2012/ AUD54969 MKMASNDAAPSNDGAAGLVPEINNETMALEPVAGGAIAAPLTGQTN n.a. n.a. n.a. GII.PNA1- FIDPWIRNNYVQAPNGEFTVSPRNSPGEILLNLELGPELNPFLAHL GII.NA1/ SRMYNGYAGGIDVQVIMAGNAFTAGKIIFAAVPPHFPIDNISPPQI Loret01041 TMFPHIIIDVRTLEPVNIPLPDVRNSFFHYSQNNEPRMRLLAMLYT PLRSNGSADDVFTVSCRVLTKPSADFEFNYLVPPTVESRTKPFTIP ILTIGEMTNSRFPVAIDMLHTSPTDNFIVQPQNGRCTLDGELQGTT QLVTSNICAFRGSISGHENNGDQHQWHFSITNPNGTPFDPTEDVPA PLGTPDFKGQLYGVISQRNREGSPGNGNQKANRSHEGVISTVAPRF TPKLGSVMIGTWTTDDIQDQPSRFTPVGLNDDDNYKQWELPNYSGA LTLNMGLAPSVFPTYPGEQLLFFRSYIPMKGGYGSPYIDCLIPQEW ISHFYQESAPSQTDVALIRYVNPDTGRVLFEAKLHRQGYITVAKTG DSPINVPANGYFREDSWVSQFYSLAPMGTGNGRRRIQ 24 GII 768/2002/ AUQ28670 MRMASSDAPVSGTDGAAGLVPESQQEVLPLEPVAGVQLAAPVAGQS n.a. n.a. n.a. TUN NIIDPWIRMNEVQAPAGEFTVSPRNAPGEVLIDLELGPELNPYLNH LARMYNGYVGGMEVEVVLAGNAFTAGKILFAAVPPSFPTHGISAAQ ATMLPHVIVDVRQLEPVRLPLPDVRNVMFHFCQENKEPRMRIVAIL YTPLRANGAGDDVFTVSCRVLTRPSPDFDFIFLVPPSVESKLKQFT LPNLQPNEMTNSREPTGITQLYTSPNTNLVVQFQNGRCLLDGTLLG TTPVRAADICSFRGVTSTEVDATDSPRVAGSHRIMVQLKEPDGEEF SPIGPNPAPVGTPDFQAAIFGTLSQRNTGGTGQNSNRAHFAYFYTR NPTFAPGIGTVVFSFDTTDFQNRQPTKFSPSGVFDDDSSEPFNQFS LPYYNGSLGAVDAGKLAPPVAPNYPGEQILYFRGNIPFKGGYGEGE IDSLLPQEWITHFYAEQAPTQGDAALLRYYNPDTGRVLFECKLHRE GFITINYTGSNALAVPVNGVFRFEGWVNKFYTLTPMGNGNGRRGRR REL 25 GII JP/2011/ AII73762 MKMASKDASPSTDGTANLVPESQQEVLALQPVAGAQIAAPVAGQFN n.a n.a. n.a Yuzawa/ VIDPWIYQNFVQAPEGEFTVSPRNSTGEILMNLELGPQLNPYLAHL Gira2HS ARMYNAYAGGFEVQVLLAGNAFTAGKIIVCAVPPNFPLQNISAAQA TQLPHVVVDVRQLEPVVLPLPDVRAGFYHYNQVEESRMRLVAILYT PLRTNSAGDDAFTVSCRILTRPAPDFSFFFLIPPTIESKTTPFTLP RLPISEMTNSRFPLVIKGMVVDPNLPLQANFQNGRITLDGELQGTT LPTSTSIGRISGTHMSSTPSRIIQHEDSGDSTQPRVENPVWMDLTE NNWTEFQPENDQPAPLGCPDFKAKILGTLIRQPNNGSYYFDAYLDT RQHGTFAPYTGHAAVHSDQQAGHLAQGYKIQFSPTGIESDQNTDLN QLPDYGGAMTVSKGLAPAAAPDFPGEMILYFVSDMPVRNPNGERRD TEILCLLPQEMVTHFYEQQAPSQGDVALVRYINAETGRVMFEGKLH RNGFFTVSATARTLIVPDGYFRFDSWVNRFYTLSPMGTGNGRRRAR MLE 26 GII QC07118/ BAJ25074 MKMASNDANPSSDGSANLVPEISNEVMALEPVAGAAIAAPVAGQQN n.a. n.a. n.a. 2007/JP IIDPWIRNNFVQAPGGEFTVSPRNAPGEVLLNLPLSPDINPYLAHL SRMYNGYAGGVEVEVVLAGNAFTAGKIIFAAVPPNFPPENLSPSQI TMLPHIIVDVRQLEPVRIPLPDVRNNFYHYSRENDSTLRLIAMLYT PLRANNAGDDVFTVSCRVLTRPSPDFDFIFLVPPTVESKSKPFTIP MLTIEEMTNSRFPAPLELMTTGPSHDIVVQPQNGRCTIDGVLLGTT QLSPVNICSLRGVPTKRINGNDNCFVQLENPNGSAYDPTEDIPAVL GSPDFVGELYGTITQRSSDNSTRAHPFTLNTGSPRYTPKIGSVDIR VTDVSDLQDHDPVKLTPVGLSGDRGSIHQWQLPNYSGVATHNMHLA PSVAPLFPGEQILFFRSTVPGCGGYPNSNIDCLIPQEWVQHFYQEG APARTDVALLRFINPDTGRVLFECKLHKHGFITVAYSGNHDLVMPP NGYFRFESWVNQFHTLAPMGTGSGRRRIQ 27 GII PE/2013/ AUD54972 MKMASNDAAPSNDGAAGLVPEINNETMALEPVAGGAIAAPLTGQTN n.a. n.a. n.a. GII.FNA2- FIDPWIRGNYVQAPNGEFTVSPRNSPGEILLNLELGPELNPFLAHL GII.NA2/ SRMYNGYAGGIDVQVIMAGNAFTAGKIIFAAVPPHFPVENISPPQI Loret01257 TMFPHIIVDVRTLEPINIPVPDVRNNFFHYNQDRDSRMRLVAMLYT PLRSNGSTDDVFTVSCRVLTKPSADFEFNYLVPPTVESRTKPFSIP ILTIGEMTNSRFPLPIDMLYTSPTENLVVQPQNGRCTTEGELLGTT QLVTPSICSLRGAITGHEGNDDDHKWHMTVTSPNGAAFDPTEDVPA PLGTPDFTGDIYGVLSQRDRNINPGQTAPANRAHEAVVSTRSNKFT PKLGSVMIATWETTDVLQQPTKFTPVGLESPNHYNQWQLPNYSGAL TLNMGLAPSVFPTYPGEQILFFRSFIPLKGGYGNSAIDCLVPQEWI QHFYQESAPSQTDVALIRYVNPETGRVLFEAKLHRQGFITVAKTGD SPINVPANGYFRFDSWVNPFYSLAPMGTGNGRRRNQ 28 GII T091/TN/ AGL98416 MKMASNDANPSDGSAANLVPEVNNEVMALEPVVGAAIAAPVAGQQN n.a. n.a. n.a. 1976 VIDPWIRNNFVQAPGGEFTVSPRNAPGEILWSMPLSPELNPYLSHL SRMYNGYAGGFEVQVILAGNAFTAGKIIFAAIPPNFPTDGLSPSQV TMFPHIIVDVRQLEPVLIPLPDVRNNFYHYNQANDSTLKLIAMLYT PLRANNAGDDVFTVSCRVLTRPSPDFDFIFLVPPTVESRTKPFTVP ILTVDEMTNSRFPTPLEKLHTGPNNSIVVQPQNGRCTIDGVLLGTT QLSTVNICNFRGSTTRAGQSHAYTMNLVSQNWNNYDPTEEIPAPLG TPDFVGKIVGMLSQTTRENSSTRAHKATVSTGDAHFTPKSGSVLFT HLAPPVAPTFPGEQLLFFRSTMPGCGGYPNMDLDCLLPQEWVRHEY QEAAPAQSDVALLRFVNPDTGRVLFECKLHKAGYITVSHTGPYDLV IPPNGYFREDSWVNQFYALAPMGTGTGRRRAL 29 GII.1 Noda485/ AAZ66776 MKMASNDAAPSNDGAAGLVPEVNNEMMALEPVAGASIAAPLTGQNN pICH99766 Yes Yes 00/JP VIDPWIRMNEVQAPNGEFTVSPRNSPGEILLNLELGPELNPFLAHL SRMYNGYAGGVEVQVLLAGNAFTAGKLVFAAIPPRFPIENLSPGQI TMFPHVIIDVRTLEPVLLPLPDVRNNFFHYNQEPEPRMRLVAMLYT PLRSNGSGDDVFTVSCRVLTRPSPDFDFNYLVPPTVESKTKPFTLP ILTIGELSNSREPAPIDELYTSPNEGLVVQPQNGRSTLDGELLGTT QLVPSNICSLRGRINAHLPDNQHRWNMQVTNANGTPFDPTEDVPAP LGTPDFLANIYGVTSQRNPDNTCRAHDGILATWSPKFTPKLGSVVL GTWEDRDFDINQPTRFTPVGLYDTDHFNQWALPNYSGALTLNMNLA PSVAPLFPGEQLLFFRSHIPLKGGTSNGAIDCLLPQEWVQHFYQES APSSTDVALIRYTNPDTGRVLFEAKLHRQGFITVANSGSRPIVVPP NGYFRFDSWVNQFYSLAPMGTGNGRRRVQ 30 GII.1 IDN/IT ASW22508 MKMASNDVAPSNDGAAGLVPEVSNETMALEPVAGASIAAPLTGQNN n.a. n.a. n.a. D11-3/ VIDPWIRMNFVQAPNGEFTVSPRNSPGEVLLNLELGPELNPFLAHL 2015/ ARMYNGYAGGVEVQVLLAGNAFTAGKLVFAAIPPHFPLENLSPGQI GII.Pg/ TMFPHVIIDVRTLEPVLLPLPDVRNNFFHYNQQPEPRMRLVAMLYT GII.1 PLRSNGSGDDVFTVSCRVLTRPSPDFDFNYLVPPTVESKTKPFTLP ILTIGELSNSRFPVPIDELYTSPNEGVVVQPQNGRSTLDGELLGTT QLVPSNICALRGRINAQVPDDHHQWNLQVTNANGTSFDPTEDVPAP LGTPDFLANIYGVTSQRNPDNTCRAHDGVLATWSPKFTPKLGSVVL GTWEESDLDLNQPTRFTPVGLYDTNHFDQWILPNYSGRLTLNMNLA PSVAPLFPGEQILFFRSHIPLKGGTSNGAIDCLLPQEWIQHFYQES APSPTDVALIRYTNPDTGRVLFEAKLHRQGFITVANSGSRPIVVPP NGYFREDSWVNQFYSLAPMGTGNGRRRVQ 31 GII.2 MK04/2004/ ABE41641 MKMASNDAAPSTDGAAGLVPESNNEVMALEPVAGAALAAPVTGQTN pICH99770 Yes Yes JP IIDPWIRANFVQAPNGEFTVSPRNAPGEVLLNLELGPELNPYLAHL ARMYNGYAGGMEVQVMLAGNAFTAGKLVFAAVPPHFPVENLSPQQI TMFPHVIIDVRTLEPVLLPLPDVRNNFFHYNQKDDPKMRIVAMLYT PLRSNGSGDDVFTVSCRVLTRPSPDFDFTYLVPPTVESKTKPFTLP ILTLGELSNSRFPVSIDQMYTSPNEVISVQCQNGRCTLDGELQGTT QLQVSGICAFKGEVTAHLHDNDHLYNVTITNINGSPFDPSEDIPAP LGVPDFQGRVFGVISQRDKHNSPGHNEPANRGHDAVVPTYTSQYTP KLGQIQIGTWQTDDLTVNQPVKFTPVGLNDTEHFNQWVVPRYAGAL NLNTNLAPSVAPVFPGERLLFFRSYIPLKGGYGNPAIDCLLPQEWV QHEYQEAAPSMSEVALVRYINPDTGRALFEAKLHRAGEMTVSSNTS APVVVPANGYFRFDSWVNQFYSLAPMGTGNGRRRVQ 32 GII.2 InaNG1/ BAD72797 MKMASNDAAPSTDGAAGLVPESNNEVMALEPVAGAALAAPVTGQTN pICK00111 Yes n.t. JP/ IIDPWIRANFVQAPNGEFTVSPRNAPGEVLLSLELGPELNPYLAHL 2002 ARMYNGYAGGMEVQVMLAGNAFTAGKLVFAAVPPHFPVENLSPQQI TMFPHVIIDVRTLEPVLLPLPDVRNNFFHYNQKDDPKMRIVAMLYT PLRSNGSGDDVFTVSCRVLTRPSPDFDFTYLVPPTVESKTKPFTLP ILTLGELSNSRFPVSIDQMYTSPNEVISVQCQNGRCTLDGELQGTT QLQVSGICAFKGEVTAHLHDNDHLYNVTITNLNGPPFDPSEDIPAP LGVPDFQGRVFGVISQRDKQNAAGHSEPANRGHDAVVPTYTAQYTP KLGQVQIGTWQTDDLQVNQPVKFTPVGLNDTEHFNQWVVPRYAGAL NLNTNLAPSVAPVFPGERLLFFRSYIPLKGGYGNPAIDCLLPQEWV QHFYQEAAPSMSEVALVRYINPDTGRALFEAKLHRAGEVTVSSNTS APVVVPANGYFREDSWVNQFYSLAPMGAGNGRRRVQ 33 GII.2 QC08154/ BAL60769 MKMASNDAVPSTDGAAGLVPESNNEVMALEPVAGAALAAPVTGQTN pICK00123 Yes n.t. JP/2008 IIDPWIRANFVQAPNGEFTVSPRNSPGEVLLNLELGPELNPYLAHL ARMYNGYAGGMEVQVMLAGNAFTAGKLVFAAVPPHFPVENDSPQQI TMFPHVIIDVRTLEPVLLPLPDVRNNFFHYNQKDDPKMRIVAMLYT PLRSNGSGDDVFTVSCRVLTRPSPDFDFTYLVPPTVESKTKPFTLP ILTLGELSNSRFPVSIDQMYTSPNEVISVQCQNGRCTLDGELQGTT QLQVSGICAFKGEVTAHLHDNEHLYNVTITNLNGSPFDPSEDIPAP LGVPDFQGRVFGVISQRDKHNTPGHNEPANRAHDAVVPTYTAQYTP KLGQVQIGTWQTDDLTDNQPVKFTPVGLNDTEHFNQWVVPRYAGAL NLNTNLAPSVAPVFPGERLLFFRSYIPLKGGYGTPAIDCLLPQEWV QHEYQEAAPSMSEVALVRYINPDTGRALFEAKLHRAGEMTVSSNTS APVVVPANGYFRFDSWVNQFYSLAPMGTGNGRRRIQ 34 GII.2 JP/2004/ BBB86933 MKMASIDAAPSTDGAAGLVPESNNEVMALEPVAGAALAAPVTGQTN n.a. n.a. n.a. GII.P2_ IIDPWIRANFVQAPNGEFTVSPRNAPGEVLLNLELGPELNPYLAHL GII.2/ ARMYNGYAGGMEVQVMLAGNAFTAGKLVFAAVPPHFPVENLSPQQI Tochigi- TMFPHVIIDVRTLEPVLLPLPDVRNNFFHYNQKDDPKMRIVAMLYT 86 PLRSNGSGDDVFTVSCRVLTRPSPDFDFTYLVPPTVESKTKPFTLP ILTLGELSNSRFPVSIDQMYTSPNEVISVQCQNGRCTLDGELQGTT QLQVSGICAFKGEVTAHLHDNDHLYNVTITNLNGSPFDPSEDIPAP LGVPDFQGRVFGVISQRDKHNSPGHNEPANRGHDAVVPTYTSQYTP KLGQIQIGTWQTDDLTVNQPVKFTPVGLNDTEHFNQWVVPRYAGAL NLNTNLAPSVAPVFPGERLLFFRSYIPLKGGYGNPAIDCLLPQEWV QHFYQEAAPSMSEVALVRYINPDTGRALFEAKLHRAGEMTVSSNTS APVVVPANGYFRFDSWVNQFYSLAPMGTGNGRRRVQ 35 GII.3 SaitamaU201/ BAB84155 MKMASNDAAPSNDGAAGLVPEINNEAMALEPVAGAAIAAPLTGQQN pICH96113 Yes Yes 98/JP IIDPWIMNNFVQAPGGEFTVSPRNSPGEVLLNLELGPEINPYLAHL ARMYNGYAGGFEVQVVLAGNAFTAGKVIFAAIPPNFPIDNLSAAQI TMCPHVIVDVRQLEPINLPMPDVRNNFFHYNQGSDSRLRLIAMLYT PLRANNSGDDVFTVSCRVLTRPSPDFSFNFLVPPTVESKTKLFTLP ILTISEMSNSRFPVPIDSLHTSPTENIVVQCQNGRVTLDGELMGTT QLLPSQICAFRGTLTRSTSRASDQADTPTPRLENHRWHIQLDNLNG TPYDPAEDIPAPLGTPDFRGKVFGVASQRNPDSTTRAHEAKVDTTS GRETPKLGSLEITTESDDFDTNQSTKFTPVGIGVDNEAEFQQWSLP NYSGQFTHNMNLAPAVAPNFPGEQLLFFRSQLPSSGGRSNGVLDCL VPQEWVQHFYQESAPAQTQVALVRYVNPDTGRVLFEAKLHKLGFMT IAKNGDSPITVPPNGYFRFESWVNPFYTLAPMGTGNGRRRIQ 36 GII.3 Texas/ BAG30939 MKMASNDATPSNDGAAGLVPEINNEAMALDPVAGAAIAAPLTGQQN pICH99781 Yes n.t. TCH04- IIDPWIMNNFVQAPGGEFTVSPRNSPGEVLLNLELGPEINPYLAHL 577/2004/ ARMYNGYAGGFEVQVVLAGNAFTAGKIIFAAIPPNFPIDNLSARQI US TMCPHVIVDVRQLEPVNLPMPDVRNNFFHYNQGSDSRLRLIAMLYT PLRANNSGDDVFTVSCRVLTRPSPDFSFNFLVPPTVESKTKPFTLP ILTISEMSNSRFPVPIDSLHTSPTENIVVQCQNGRVTLDGELMGTT QLLPSQICAFMGVLTRSTSRASDQADTATPRLENYYWHIQLDNPNG TPYDPAEDIPGPLGTPDFRGKVFGVASQRNPDSTTRAHEAKVDTTA GRFTPKLGSLEISTESDDFHQNQPTRFTPVGIGVDNEADFQQWSLP DYSGQFTHNMNLAPAVAPNFPGEQLLFFRSQLPSSGGRSNGILDCL VPQEWVQHFYQESAPSQTQVALVRYVNPDTGRVLFEAKLHKLGFMT IAKNGDSPITVPPNGYFRFESWVNPFYTLAPMGTGNGRRRIQ 37 GII.3 Kashiwa336/ AAZ66774 MKMASNDAAPSNDGAAGLVPEINNEAMALDPVAGAAIAAPLTGQQN pICH99798 Yes n.t. 00/JP IIDPWIMNNFVQAPGGEFTVSPRNSPGEVLLNLELGPEINPYLAHL ARMYNGYAGGFEVQVVLAGNAFTAGKVIFAAIPPNFPIDNLSAAQI TMCPHVIVDVRQLEPINLPMPDVRNNFFHYNQGSDSRLRLIAMLYT PLRANNSGDDVFTVSCRVLTRPSPDFSFNFLVPPTVESKTKPFTLP ILTISEMSNSRFPVPIDSLHTSPTESVVVQCQNGRVTLDGELMGTT QLLPSQICAFRGTLTRPTNRASDQADTATPRLENHQWHIQLDNLNG TPYDPAEDIPAPLGTPDFRGKVFGVASQRDPDGTTRAHEAKVDTTS GRETPKLGSLEITTESDDENQNKPTRETPVGIGVDNEADFQQWILP DYSGQFTHNMNLAPAVAPNFPGEQLLFFRSQLPSSGGRSNGILDCL VPQEWVQHFYQESAPAQTQVALVRYVNPDTGRVLFEAKLHKMGEMT IAKNGDSPITVPPNGYFRFESWVNPFYTLAPMGTGKGRRRIQ 38 GII.3 HKG/2014/ AHZ12739 MKMASNDATPSNDGAAGLVPEINNEAMALDPVAGAAIAAPLTGQQN pICH99803 Yes n.t. CUHK-NS- IIDPWIMNNFVQAPGGEFTVSPRNSPGEVLLNLELGPEINPYLAHL 232 ARMYNGYAGGFEVQVVLAGNAFTAGKIIFAAIPPNFPIDNLSAAQI TMCPHVIVDVRQLEPVNLPMPDVRNNFFHYNQGSDSRLRLVAMLYT PLRANNSGDDVFTVSCRVLTRPSPEFSFNFLVPPTVESKTKPFTLP ILTISEMSNSRFPVPIDSLHTSPTENIVVQCQNGRVTLDGELMGTT QLLPSQICAFRGVLTRSTSRTSDQADTATPRLENYYWHIQLDNING TPYDPAEDIPGPLGTPDFRGKVFGVASQRNPDSTTRAHEAKVDTTA GRETPKLGSLEISTESGDFDQNQPTRFTPVGIGVDHEADFQQWSLP DYSGQFTHNMNLAPAVAPNFPGEQLLFFRSQLPSSGGRSNGILDCL VPQEWVQHFYQESAPAQTQVALVRYVNPDTGRVLFEAKLHKLGFMT IAKNGDSPITVPPNGYFRFESWVNPFYTLAPMGTGNGRRRVQ 39 GII.3 Tokyo/ BAK43275 MKMASNDAAPSNDGAAGLVPEINNEAMALEPVAGAAIAAPLTGQQN n.a. n.a. n.a. 10- IIDPWIMNNEVQAPGGEFTVSPRNSPGEVLLNLELGPEINPYLAHL 1105/2010/ ARMYNGYAGGFEVQVVLAGNAFTAGKIIFAAIPPNFPIDNLSAAQI JPN TMCPHVIVDVRQLEPVNLPMPDVRNNFFHYNQGSDSRLRLVAMLYT PLRANNSGDDVFTVSCRVLTRPSPDFSFNFLVPPTVESKTKPFTLP ILTISEMSNSRFPVPIDSLHTSPTENIVVQCQNGRVTLDGELMGTT QLLPSQICAFRGVLTRSTSRASDQADTATPRLENYYWHIQLANLNG TPYDPAEDIPGPLGTPDFRGKVFGVACQRNPDCTTRAHEAKVDTTA GRETPKLGSLEISTESGDFDQNQPTRFTPVGIGVDHEADFQQWSLP DYSGQFTHNMNLAPAVAPNFPGEQLLFFRSQLPSSGGRSNGILDCL VPQEWVQHFYQESAPAQTQVALVRYVNPDTGRVLFEAKLHKLGFMT IAKNGDSPITVPPNGYFRFESWVNPFYTLAPMGTGNGRRRIQ 40 GII.4 Aomori2/ BAG70446 MKMASSDANPSDGSTANLVPEVNNEVMALEPVVGAAIAAPVAGQQN pICH96125 Yes Yes 2006/ VIDPWIRNNFVQAPGGEFTVSPRNAPGEILWSAPLGPDLNPYLSHL JP ARMYNSYAGGFEVQVILAGNAFTAGKIIFAAVPPNFPTEGLSPSQV TMFPHIIVDVRQLEPVLIPLPDVRNNFYHYNQSNDPTIKLIAMLYT PLRANNAGDDVFTVSCRVLTRPSPDFDFIFLVPPTVESRTKPFSVP ILTVEEMTNSRFPIPLEKLETGPSSAFVVQPQNGRQTTDGVLLGTT QLSPVNICTFRGDVTHIAGTQEYTMNLASQNWNNYDPTEEIPAPLG TPDFVGKIQGVLTQTTRRDGSTRGHKATVSTGSVHFTPKLGRIQFS TDTSNDFETGQNTRFTPVGVVQDGSTTHQNEPQQWVLPNYSGRDSH NVHLAPAVAPSFPGEQLLFFRSTMPGCSGYPNMNLDCLLPQEWVQH FYQEAAPAQSDVALLREVNPDTGRVLFECKLHKSGYVTVAHTGQHD LVIPPNGYFREDSWVNQFYTLAPMGNGTGRRRAL 41 GII.4 Sydney/ AFV08795 MKMASSDANPSDGSAANLVPEVNNEVMALEPVVGAAIAAPVAGQQN pICH96137 Yes Yes NSW0514/ VIDPWIRNNEVQAPGGEFTVSPRNAPGEILWSAPLGPDLNPYLSHL 2012/AU ARMYNGYAGGFEVQVILAGNAFTAGKVIFAAVPPNFPTEGLSPSQV TMFPHIVVDVRQLEPVLIPLPDVRNNFYHYNQSNDPTIKLIAMLYT PLRANNAGDDVFTVSCRVLTRPSPDFDFIFLVPPTVESRTKPFSVP VLTVEEMTNSRFPIPLEKLFTGPSSAFVVQPQNGRCTTDGVLLGTT QLSPVNICTFRGDVTHITGSRNYTMNLASQNWNDYDPTEEIPAPLG TPDFVGKIQGVLTQTTRTDGSTRGHKATVYTGSADFAPKLGRVQFE TDTDRDFEANQNTKFTPVGVIQDGGTTHRNEPQQWVLPSYSGRNTH NVHLAPAVAPTFPGEQLLFFRSTMPGCSGYPNMDLDCLLPQEWVQY FYQEAAPAQSDVALLREVNPDTGRVLFECKLHKSGYVTVAHTGQHD LVIPPNGYFREDSWVNQFYTLAPMGNGTGRRRAV 42 GII.4 NIHIC35/ AGX85919 MKMASNDANPSDGSAANLVPEVNNEVMALEPVVGAAIAAPVAGQQN pICH99812 Yes n.t. 2013/ VIDPWIRNNFVQAPGGEFTVSPRNAPGEILWSAPLGPDLNPYLSHL USA ARMYNGYAGGFEVQVILAGNAFTAGKIIFAAVPPNFPTEGLSPSQV TMFPHIIVDVRQLEPVLIPLPDVRNNFYHYNQSNDSTIKLIAMLYT PLRANNAGDDVFTVSCRVLTRPSPDFDFIFLVPPTVESRTKPFSVP ILTVEEMTNSRFPIPLEKLETGPSSTEVVQPQNGRCTTDGVLLGTT QLSPVNICTFRGDVTHIAGSRNYTMNLASQNWNSYDPTEEIPAPLG TPDFVGKIQGVLTQTTRTDGSTRGHKATVYTGSADFSPKLGRVQFA TDTENDFVTNQNTKFTPVGVIQDGGTTHRNEPQQWVLPSYSGRNTH NVHLAPAVAPTFPGEQLLFFRSTMPGCSGYPDMDLDCLLPQEWIQY FYQEAAPAQSDVALLRFVNPDTGRVLFECKLHKSGYVTVAHTGQHD LVIPPNGYFREDSWVNQFYTLAPMGNGTGRRRAL 43 GII.4 NU/2014/ CRL46961 MKMASSDANPSDGSAANLVPEVNNEVMALEPVVGAAIAAPVAGQQN pICH99829 Yes n.t. GII.4/ VIDPWIRNNFVQAPGGEFTVSPRNAPGEILWSAPLGPDLNPYLSHL Groningen01 ARMYNGYAGGFEVQVILAGNAFTAGKIIFAAVPPNFPTEGLSPSQV TMFPHIIVDVRQLEPVLIPLPDVRNNFYHYNQSNDSTIKLIAMLYT PLRANNAGDDVFTVSCRVLTRPSPDFDFIFLVPPTVESRTKPFSVP VLTVEEMTNSRFPIPLEKLFTGPSSAFVVQPQNGRCTTDGVLLGTT QLSPVNICTFRGDVSHITGSRNYTMNLASQNWNNYDPTEEIPAPLG TPDEVGKIQGMLTQTTRADGSTRGHKATVYTGSADFAPKLGRVQFE TDTDHDFEANQNTKFTPVGVIQDGSTTHRNEPQQWVLPSYSGRNTH NVHLAPAVAPTFPGEQLLFFRSTMPGCSGYPNMDLDCLLPQEWVQY FYQEAAPAQSDVALLREVNPDTGRVLFECKLHKSGYVTVAHTGQHD LVIPPNGYFREDSWVNQFYTLAPMGNGTGRRRAV 44 GII.4 Sequence 1 n.a. MKMASNDANPSDGSTANLVPEVNNEVMALEPVVGAAIAAPVAGQQN pICK02813 Yes Yes from VIDPWIRNNFVQAPGGEFTVSPRNAPGEILWSAPLGPDLNPYLSHL US20160168543 ARMYNGYAGGFEVQVILAGNAFTAGKIIFAAVPPNFPTEGLSPSQV TMFPHIIVDVRQLEPVLIPLPDVRNNFYHYNQSNDSTIKLIAMLYT PLRANNAGDDVFTVSCRVLTRPSPDFDFIFLVPPTVESRTKPFTVP ILTVEEMSNSRFPIPLEKLYTGPSSAFVVQPQNGRCTTDGVLLGTT QLSAVNICTFRGDVTHIAGSHDYTMNLASQNWNNYDPTEEIPAPLG TPDFVGKIQGLLTQTTREDGSTRAHKATVSTGSVHFTPKLGSVQYT TDTNNDFQTGQNTKFTPVGVIQDGNNHQNEPQQWVLPNYSGRTGHN VHLAPAVAPTFPGEQLLFFRSTMPGCSGYPNMNLDCLLPQEWVQHE YQEAAPAQSDVALLREVNPDTGRVLFECKLHKSGYVTVAHTGPHDL VIPPNGYFRFDSWVNQFYTLAPMGNGAGRRRAL 45 GII.4 Hong AEG79288 MKMASNDANPSDGSAANLVPEVNNEVMALEPVAGAALAAPVAGQQN n.a. n.a. n.a. Kong/ VIDPWIRNNEVQAPGGEFTVSPRNAPGEILWSAPLSPDLNPYLSHL CUB001/ ARMYNSYAGGFEVQVILAGNAFTAGKIIFAAVPPNFPIEGLSPSQV 2010/CHN TMFPHIIVDVRQLEPVLIPLPDVRNNFYHYNQTNEPTIKLIAMLYT PLRANNAGEDVFTVSCRVLTRPSPDFDFIFLVPPTVESRTKPFTVP ILTVEEMTNSRFPIPLEKLFTGPSSSFVVQPQNGRCTTDGVLLGTT QLSPVNICTFRGDVTHIAGSRNYTMNLASINWNNYDPTEEIPAPLG TPDFVGKIQGMLTQTTRGEGSTRAHRATVYTGSAPFTPKLGSVQFT TDTDNDFDANQNTKFTPVGVIQDGDTAHRNEPQQWVLPSYSGRNVQ NVHLAPAVAPTFPGEQLLFFRSTMPGCSGYPNMDLDCLLPQEWVQH FYQEAAPAQSDVALLREVNPDTGRVLFECKLAKSGYVTVAHTGQHD LVIPPNGYFREDSWVNQFYTLAPMGNGAGRRRAL 46 GII.4 3.10 AQU14484 MKMASNDANPSDGSAANLVPEVNNEVMALEPVVGAAIAAPVAGQQN n.a. n.a. n.a. VIDPWIRNNFVQAPGGEFTVSPRNAPGEILWSAPLGPDLNPYLSHL ARMYNGYAGGFEVQVILAGNAFTAGKIIFAAVPPNFPTEGLSPSQV TMFPHIIVDVRQLEPVLIPLPDVRNNFYHYNQSNDSTIKLIAMLYT PLRANNAGDDVFTVSCRVLTRPSPDFDFIFLVPPTVESRSKPFSVP VLTVEEMTNSRFPATLDKLETGPSSTEVVQPQNGRCMIDGVLLGTT QLSPVNICTFRGDVTHLRDSPIYTMNLASPNWNNYDSTEEIPAPLG TPDFVGKIQGVLTQTTKGEGSTRGHRATVYVGSANYTPKLGKVQFE TNTTNDLYAHQNTKFTPVGVVQGGESAHRSEPQQWVLPGYSGRDTP NVHLAPAVAPTFPGEQLLFFRSTIPGCGGHPNMDLDCLLPQEWVQH FYQEAAPAQSDVALLREVNPDTSRVLFECKLHKSGYVTVAHTGQHD LVIPPNGYFREDSWVNQFYTLAPMGNGTGRKRAI 47 GII.4 2.8b AQU14462 MKMASSDANPSDGSAANLVPEVNNEVMALEPVVGAAIAAPVAGQQN n.a. n.a. n.a. VIDPWIRNNFVQAPGGEFTVSPRNAPGEILWSAPLGPDLNPYLSHL ARMYNGYAGGFEVQVILAGNAFTAGKIIFAAVPPTFPTEGLSPSQV TMFPHIIVDVRQLEPVLIPLPDVRNNFYHYNQSNDSTIKLIAMLYT PLRANNPGDDVFTVSCRVLTRPSPDFDFIFLVPPTVESRTKPFSVP ILTVGEMTNSRFPINLERLFTGPSSANVVQPQNGRCTIDGELLGTT QLSSVNICTFRGDVTHIGSTHHWTMNLASPNWNNYDPTEETPAPLG TPDEVGKIHGMLTQTTQGNGSTRGHRATVYVGSAEFTPKLGKVQFK TETDHDLAIRQNTKFTPVGVIQESDHHRDEPQQWRLPNYSGANTEN VHLAPAVAPNFPGEQLLFFRSTLPGCGGHPNMDLDCLLPQEWVQHF YQEAAPAQSDVALLREVNPDTSRVLFECKLHKSGYVTVAHTGQYDL VLPSNGYFRFDSWVNQFYTLAPMGNGTGRRRAL 48 GII.4 patientC/ AHH44895 MKMASNDASPSDGSAANLVPEVNNEVMALEPVVGAAIAAPVAGQQN n.a. n.a. n.a 2010/USA VIDPWIRNNFVQAPGGEFTVSPRNAPGEILWSAPLGPDLNPYLSHL ARMYNGYAGGFEVQVILAGNAFTAGKIIFAAVPPNFPTEGLSPSQV TMFPHIVVDVRQLEPVLIPLPDVRNNFYHYNQSKDPTIKLIAMLYT PLRANNAGEDVFTVSCRVLTRPSPDFDFIFLVPPTVESRSKPFTVP ILTVEEMTNSRFPIPLEKLFTGPSGAFVVQPQNGRCTTDGVLLGTT QLSPVNICTFRGDLTHFTGTSEYAMNLASQNWDNYDPTEEIPAPLG APDFVGKIRGMLTQTTRRDGSTRGHRATLSTGSAHFTPKLGNIRES TDTNNDFEAGQNTKFTPVGVFQEGDNHQNEPQQWVLPNYSGATAHN VHLAPAVAPAFPGEQLLFFRSTMPGCGGYPNMNLDCLLPQEWVQHF YQEAAPAQSDVALLREVNPDTSRVLFECKLHKSGYVTVAHTGQHDL VIPPNGYFREDSWVNQFYTLAPMGNGTGRRRAL 49 GII.4 NIHIC18/ AGX85889 MKMASSDANPSDGSTANLVPEANNEVMALEPVVGAAIAAPVAGQQN n.a n.a. n.a. 2012/USA VIDPWIRNNEVQAPGGEFTVSPRNAPGEILWSAPLGPDLNPYLSHL SRMYNGYAGGFEVQVILAGNAFAAGKIIFAAVPPNFPTEGLSPSQV TMFPHLIVDVRQLEPVMIPLPDIRNNFYHYNQSNDPTIKLIAMLYT PLRANNVGDDVFTVSCRVLTRPSPDFDFIFLVPPTVESKTNPFSVP ILTIEEMTNSRFPIPLEKLFTGPSSALVVQPQNGRCTTDGVLLGTT QLSPVNICTFRGDVTHTTKTHTYQMNLAAQNWNSYDPTEEIPAPLG TPDFVGKIQGVLTQTTKGNGSTRAHKATVYTGSAEFTPKLGRIQLF TDTDNDLEANQNTKFTPVGVIQDGDTHQNEPQQWVLPSYSGRNNHN VHLAPAVAPTFPGEQLLFFRSTMPGCSGYPNMNLDCLLPQEWVQYF YQEAAPAQSDVALLREVNPDTGRVLFECKLHKSGYVTVAHTGHHDL FIPPNGYFRFDSWVSPFYTLAPMGNGTGRRRAL 50 GII.4 patientA/ AHH44878 MKMASSDANPSDGSAANLVPEVNNEVMALEPVVGAAIAAPVAGQQN n.a. n.a. n.a. 2010/USA VIDPWIRNNFVQAPGGEFTISPRNAPGEILWSAPLGPDLNPYLSHL ARMYNGYAGGFEVQVVLAGNAFTAGKIIFAAVPPNFPTEGLSPSQV TMFPHIIVDVRQLEPVLIPLPDVRNNFYHYNQSKDSTIKLIAMLYT PLRANNAGDDVFTVSCRVLTRPSPDFDFIFLVPPTVESRTKPFSVP VLTVEEMTNSRFPIPLEKLFTGPSSAFVVQPQNGRCTTDGVLLGTT QLSAVNICTFRGDVTHVAGDTFAMNLASLNWNNYDPTEETPAPLGT PDFVGRIHGMLTQTTRSDGATRAHKATVSTGGADFTPKLGSVRYST DTSSDLEVRENTKFTPIGVLHSSGGHRAEPDQWRLPEYSGRNVHNV HLAPAVAPTFPGEQLLFFRSTMPGCGGYPNMDLDCLLPQEWVQHFY QEAAPAQSDVALLRFVNPDTGRVLFECKLHKSGYVTVAHTGPHDLV IPPNGYFREDSWVNQFYTLAPMGNGTGRRRAL 51 GII.4 3- BAW33648 MKMASSDANPSDGSAANLVPEVNNEVMALEPVVGAAIAAPVAGQQN n.a. n.a. n.a. 157/Tokyo/ IIDPWIRNNFVQAPGGEFTVSPRNAPGEILWSAPLGPDLNPYLSHL 1994/JPN SRMYNGYAGGFEVQVILAGNAFTAGKVIFAAVPPNFPTEGLSPSQV TMFPHIIVDVRQLEPVLIPLPDVRNNFYHYNQSHDSTLKLIAVLYT PLRTNNAGDDVFTVSCRVLTRPSPDFDFIFLVPPTVESRTKPFTVP ILTVEEMSNSRFPIPLEKLYTGPSSAFVVQPQNGRCTTDGVLLGTT QLSAVNICNFRGDVTHIVGSHETTMNLASQNWSNYDPTQKIPAPLG TPHFVGKIQGLLTQTTRAHGSTRAHKATVSTGSVHFTPKLGSVQFT TDTNNDFQTGQNTKFTPVGVIQDGDHHQNEPQQWVLPNYSGRIGHN VHLAPAVAPTFPGEQLLFFRSTMPGCSGYPNMNLDCLLPHEWVLHE YQEAAPAQSDVALLRFVNPDTGRVLFECKLHKSGYITVAHTGPFDL GIPPNGYFRFDSWVNQFYTLAPMGNGTGRRRAL 52 GII.4 Beijing/ ABD77588 MKMASNDASPSDGSTANLVPEVNNEVMALEPVVGAAIAAPVAGQQN n.a. n.a. n.a. CR2905/ VIDPWIRNSSVQAPGGEFTVSPRDAPGEILWSAPLGPDLNPYLSHL 2004/CHN ARMYNGYAGGFEVQVILAGNAFTAGKIIFAAAPPNFPTEGLSPSQV TMFPHIIVGVRQLEPVLIPLPDVRNNFYHYNQSNDSTIKLIAMLYT PLRANNAGDDVFTVSCRVLTRPSPDFDFIFLVPPTVESRTKPFTVP ILTVEEMTNSRFPIPLENCSRVPAVPLSSNHKMQCTTDGVLLGTTQ LSPVNICTFRGDVTHIPGTRTYRMNLASQNWNNYDPTEEIPAPLGT PDFVGKIQGMLTQTTKGDGSTRGHKATVSTGSVDFTPKLGSVQFAT DTDNDFETGQNTRFTPVGVIQDGSSTHRNEPQQWVLPDYSGRTVHN VHLAPAVAPTFPGEQLLFFRSTMPGCSGYPNMDLDCLLPQEWVQHE YQEAAPSQSDVALLRFVNPDTGRVLFECKLHKAGYVTVAHTGQHDL VIPPNGYFREDSWVNQFYTLAPMGNGAGRRRAL 53 GII.4 KL45/1978/ AGE99612 MKMASSDANPSDGSSANLVPEVNNEVMALEPVVGAAIAAPVAGQQN n.a. n.a. n.a. MYS IIDPWIRNNFVQAPGGEFTVSPRNAPGEILWSAPLSPDLNPYLSHL SRMYNGYAGGFEVQVILAGNAFTAGKIVFAAVPPNFPTEGLSPSQV TMFPHIIVDVRQLEPVLIPLPDVRNNFYHYNQANDSTLKLIAMLYT PLRANNAGDDVFTVSCRVLTRPSPDFDFIFLVPPTVESRTKPFTVP VLTVEEMTNSRFPIPLERLFTGPSTAFVVQPQNGRCTTDGVLLGTT QLSAVNICNFRGEVNHIAGTHDYTMRLTSQNWNNYDPTEEIPAPLG TPDFVGRIQGVLTQTTRSDGSTRSHKATVSTGSVHFTPKLGSVQFT TDTTNDLNAGQNTKFTPVGVEQTSGDHQSEPQQWTLPNYSGTPNHN VHLAPAVAPTFPGEQLLFFRSTLPGCGGYPNMNLDCLLPQEWVLHE YQEAAPAQSDVALLREVNPDTGRVLFECKLHRSGFITVAHSGSHDL VIPPNGYFRFDSWVNQFYTLAPMGNGSGRRRVV 54 GII.4 32-15 AND99841 MKMASSDANPSDGSTASLVPEVNNEVMALEPVVGAAIAAPVAGQQN n.a. n.a. n.a. VIDPWIRNNFVQAPGGEFTVSPRNAPGEILWSAPLGPDLNPYLSHL ARMYNGYAGGFEVQVILAGNAFTAGKIIFAAVPPNFPTEGLSPSQV TMFPHIIVDVRQLEPVLIPLPDVRNNFYHYNQSNDSTIKLIAMLYT PLRANNAGDDVFTVSCRVLTRPSPDFDFIFLVPPTVESRTKPFSVP ILTVEEMTNSRFPIPLEKLETGPSSTEVVQPQNGRCTTDGVLLGTT QLSPVNICTFRGGITRIGQSESYKMNLASQNWNNYDPTEEIPAPLG TPDFKGRIRGLLTQTTKGAGSTRGHKATVLTGGSDFTPKLGTVRFD TKSIDFENNQNTKFTPVGVVQDGNNHDEPTQWVLPNYSGPDTHNVH LAPAVAPTFPGEQLLFFRSTMPGCSGYPKMELDCLLPQEWVQHFYQ EAAPAQTDVALLREVNPDTGRVLFECKLHKSGYVTVAHTGDHDLVI PPNGYFRFDSWVNQFYTLAPMGNGTGRRRAL 55 GII.5 JP/2002/ AII73753 MKMASNDATPSNDGAAGLVPESNNEAMALEPVVGASLAAPVTGQTN n.a. n.a. n.a. GII.P5_ IIDPWIRTNEVQAPNGEFTVSPRNSPGEILVNLELGPELNPYLAHL GII.5/ ARMYNGYAGGMEVQVMLAGNAFTAGKIIFAAVPPYFPVENLSPSQI Saitama/T52 TMFPHVIIDVRTLEPVLLPMPDVRSTLFHENQKDEPKMRLVAMLYT PLRSNGSGDDVFTVSCRILTRPSPEFDFTYLVPPTVESKTKPFTLP VLTLGELSNSRFPLSIDEMVTSPNESIVVQPQNGRVTLDGELLGTT QLQACNICSIRGKVTGQVPNEQHMWNLQITNLNGTQFDPTDDVPAP LGVPDFAGEVFGVLSQRNRGESNPANRAHDAVVATYSDKYTPKLGL VQIGTWNINDVENQPTKFTPIGLNEVANGHRFEQWTLPRYSGALTL NMNLAPAVAPLFPGERLLFFRSYVPLKGGFGNPAIDCLVPQEWVQH FYQESAPSLGDVALVRYVNPDTGRVLFEAKLHKGGFLTVSSTSTGP VVVPANGYFREDSWVNQFYSLAPMGTGNGRRRFQ 56 GII.6 Ueno7k/ BAC05518 MKMASNDAAPSNDGAANLVPEANDEVMALEPVVGASIAAPVVGQQN pICH99834 Yes Yes 94/JP IIDPWIRENFVQAPQGEFTVSPRNSPGEMLLNLELGPELNPYLSHL SRMYNGYAGGMQVQVVLAGNAFTAGKIIFAAVPPHFPVENISAAQI TMCPHVIVDVRQLEPVLLPLPDIRNRFFHYNQENTPRMRLVAMLYT PLRANSGEDVFTVSCRVLTRPAPDFEFTFLVPPTVESKTKPFTLPI LTLGELSNSRFPAAIDMLYTDPNESIVVQPQNGRCTLDGTLQGTTQ LVPTQICAFRGTLISQTARAADSTDSPQRARNHPLHVQVKNLDGTQ YDPTDDIPAVLGAIDFKGTVFGVASQRDVSGQQEQGHYATRAHEAH IDTTDPKYAPKLGTILIKSGSDDFNTNQPIRFTPVGMGDNNWRQWE LPDYSGRLTLNMNLAPAVSPSFPGERILFFRSIVPSAGGYGSGYID CLIPQEWVQHFYQEAAPSQSAVALVRYVNPDTGRNIFEAKLHREGF LTVANCGNNPIVVPPNGYFRFEAWGNQFYTLAPMGSGQGRRRAQ 57 GII.6 Sanbu445/ AAZ66775 MKMASNDAAPSNDGAANLVPEANNEVMALEPVVGASIAAPVVGQQN pICH99848 Yes n.t. 00/JP LIDPWIRENFVQAPQGEFTVSPRNSPGEMLLNLELGPELNPYLSHL SRMYNGYAGGMQVQVVLAGNAFTAGKIIFAAVPPHFPVDNISAAQI TMCPHVIVDVRQLEPVLLPLPDIRNREFHYNQENTPRMRLVAMLYT PLRANSGEDVFTVSCRVLTRPAPDFEFTFLVPPTVESKTKPFTLPI LTLGELSNSRFPAAIDMLYADENESIVVQPQNGRCTLDGTLQGTTQ LVPTQICAFRGTLISQTARATDSTDSPQRARDHPLHVQVKNLDGTQ YDPTDDIPAVLGAIDFKGTVFGVASQRDVSGPQEQGHYATRAHEAH IDTTDPKYAPKLGTILIKSESNDFITNQPIRFTPVGMGDNNWRQWE LPDYSGRLTLNMNLAPAVSPSFPGERILFFRSIVPSAGGYGSGYID CLIPQEWGQHFYQEAAPSQSAVALVRYVNPDTGRNIFEAKLHREGE LTVANSGNNPIVVPPNGYFRFEAWVNQFYTLAPMGSGQGRRRAQ 58 GII.6 Ehime090549/ BAN16287 MKMASNDAAPSNDGAANLVPEANNEVMALEPVAGASIAAPVVGQQN n.a. n.a. n.a. 2009/JP IIDPWIRENFVQAPQGEFTVSPRNSPGEMLLNLELGPELNPYLSHL SRMYNGYAGGMQVQVVLAGNAFTAGKIIFAAVPPHFPVKNISAAQI TMCPHVIVDVRQLEPVLLPLPDIRNRFFHYNQENTPRMRLVAMLYT PLRANSGEDVFTVSCRVLTRPAPDFEFTFLVPPTVESKTKPFTLPI LTLGELSNSRFPAPIDMLYTDPNEGIVVQPQNGRCTLDGTLQGTTQ LVPTQICAFRGTLIGQTSRSSDSTDSAPRRRDHPLHVQLKNLDGTQ YDPTDEVPAVLGAIDFKGTVFGVASQRDVSGQQVGATRAHEVHINT TDPRYTPKLGSILIHSESDDFVTGQPVRFTPIGMGDNDWHQWELPD YSGHLTLNMNLAPAVAPAFPGERILFFRSMVPSAGGYGSGQIDCLI PQEWVQHFYQEAAPSQSAVALIRYVNPDTGRNIFEAKLHREGFITV ANSGNNPIVVPHNGYFRFEAWVNQFYTLTPMGTGQGRRRNQ 59 GII.7 Qsaka10- BD011881 MKMASNDAAPSSDGAAGLVPEINNEVMPLEPVAGASLATPVVGQQN pICH99850 Yes n.t. 25/99/JP IIDPWIRNNFVQAPAGEFTVSPRNSPGEILLDLELGPDLNPYLAHL ARMYNGHAGGMEVQIVLAGNAFTAGKIIFAAIPPGFPYENLSPSQI TMCPHVIIDVRQLEPFLLEMPDIWNNFFHYNQGNDPKLRLVAMLYT PLRANNSGDDVFTVSCRVLTKPSPDFEFTFLVPPTVESKTKQFALP ILKISEMTNSRFPVPVDVMYTARNENQVVQPQNGRVTLDGELLGTT PLLAVNICKFKGEVIAKNGDVRSYRMDMEITNTDGTPIDPTEDTPG PIGSPDFQGILFGVASQRNKNEQNPATRAHEAIINTGGDHLCPQIS SSETYLTSPNILRCTNPQPLPQSGLRGTILIRSDNGHCHDMVGTSP TTPTWPQQWRRCSRGSNCCSSGHRYPVPVVMNRVTWIVLSHKSGFS TSTRKLPQLNLRWPLIRFINPDTGRVLFEARLHKQGFITVAHTGDN PIVMPPNGYFRFEAWVNQFYSLAPVGTGKGRRRVQ 60 GII.7 JP/2010/ AII73774 MKMASNDAAPSNDGAAGLVPEINNEVMPLEPVAGASLATPVVGQQN n.a. n.a. n.a. GII.P7_ IIDPWIRNNFVQAPAGEFTVSPRNSPGEILLDLELGPELNPYLAHL GII.7/ ARMYNGHAGGMEVQIVLAGNAFTAGKIIFAAIPPGFPYENLSPSQI Musas TMCPHVIIDVRQLEPVLLPMPDIRNNFFHYNQGNDPKLRLIAMLYT himura PLRANNSGDDVFTVSCRVLTKPSPDFEFTFLVPPTVESKTKQFTLP yama/ ILKISEMTNSRFPVPVEMMYTARNENQVVQPQNGRVTLDGELLGTT TAKAsanKimchi PLLAVNICKFKGEVIAKNGDVRSYRMDMEITNTDGTPIDPTEDTPG PIGSPDFQGILFGVASQRNKNEQNPATRAHEANINTGGDQYAPKLA QVKFFSESQDFEVHQPTVFTPVGVAGDTSHPFRQWVLPRYGGHLTN NTHLAPAVAPLFPGEQILFFRSQIPSSGGHELGYMDCLVPQEWVQH FYQEAATAQSEVALIRFINPDTGRVLFEAKLHKQGFITVAHTGDNP IVMPPNGYFRFEAWVNQFYSLAPVGTGNGRRRIQ 61 GII.8 JC231/ ATI15126 MKMASNDAAPSNDGAAGLVPEINHEVMAIEPVAGASLAAPVVGQLN n.a. n.a. n.a. ZS/GD/ IIDPWIRNNEVQAPAGEFTVSPRNAPGEFLLDLELGPELNPYLAHL CHN/2016 ARMYNGHAGGMEVQIVLAGNAFTAGKILFAVIPPGFPYENLSPAQL TMCPHVVVDVRQLEPILLPMPDIRNTFFHYNQSNGPKLRLVAMLYT PLRANNAGDDVFTVSCRVLTRPSPDFEFNFLVPPSVESKTKAFTLP ILKISEMTNSRFPIPVDQMYTSRNENVVVQPQNGRVTLDGELQGTT TLQPVSICGFRGTLQTRLADQPNYTYQVHLENLDGSPVDPTDEVPA PLGTPDFQAQLFGVVSQRSSDNATRAHEARVNTNDPTFAPQIAQVR FKSPSHDFFDNEPIKFTPVGISVDSENSYNQWLLPRYGGHLTNNTH LAPSVSPMFPGEQILFFRSFMPGASGHTDGAIDCLLPQEWVAHFYQ EAATAQTDVALIRFVNPDTGRVLFEGKLHKQGFITISNSGDHPIVM PANGYFRFEAWVNQFYSLAPVGTGSGRRRIQ 62 GII.12 Hu/GII. AGT39194 MKMASNDAAPSNDGAAGLVPEVNNETMALEPVAGASIAAPLTGQNN n.a. n.a. n.a. 12/CGMH39/ VIDPWIRLNFVQAPNGEFTVSPRNSPGEVLLNLELGPELNPYLAHL 2010/TV SRMYNGYAGGVEVQVLLAGNAFTAGKLVFAAVPPHFPLENISPGQI TMFPHVIIDVRTLEPVLLPLPDVRNNFFHYNQQNEPRMRLVAMLYT PLRSNGSGDDVFTVSCRVLTRPSPDFDFNYLVPPTVESKTKPFTLP ILTIGELTNSRFPVPIDELYTSPNESLVVQPQNGRCALDGELQGTT QLLPTAICSFRGRINQKVSGENHVWNMQITNINGTPFDPTEDVPAP LGTPDFSGKLFGVLSQRDHDNACRSHDAVIATNSAKFTPKLGAIQI GTWEQDDVHINQPTKFTPVGLFESEGFNQWTLPNYSGALTLNMGLA PPVAPTFPGEQILFFRSHIPLKGGVADPVIDCLLPQEWIQHLYQES APSQTDVALIRFTNPDTGRVLFEAKLHRSGYITVANTGSRPIVVPA NGYFREDSWVNQFYSLAPMGTGNGRRRVQ 63 GII.13 Kashiwa47/ BAC05515 MKMASNDAAPSNDGAASLVPEGINETMPLEPVAGASIAAPVAGQTN pICH99861 Yes n.t. 97/JP IIDPWIRTNEVQAPNGEFTVSPRNSPGEILLNLELGPDLNPYLAHL SRMYNGYAGGVEVQVLLAGNAFTAGKILFAAIPPNFLVDMISPAQI TMLPHLIVDVRTLEPIMTPLPDVRNVFYHENNQPQPRMRLVAMLYT PLRSNGSGDDVFTVSCRVLTRPTPDFEFIYLVPPSVESKTKPFTLP ILTISELTNSRFPIPIEQLYTAPNETNVVQCQNGRCTLDGELQGTT QLLSSAVCFLQGRTVADNGDNWDQNLLQLTYPNGASYDPTDEVPAP LGTQDFSGMLYGVLTQDNVNVSTGEAKNAKGIYISTTSGKFTPKIG SIGLHSITEHVHPNQQSRFTPVGVAVDENTPFQQWVLPHYAGSLAL NTNLAPAVAPTFPGEQLLFFRSRVPCVQGLQGQDAFIDCLLPQEWV NHFYQEAAPSQADVALIRYVNPDTGRTLFEAKLHRSGFITVSHTGA YPLVVPPNGHFRFDSWVNQFYSLAPMGTGNGRRRIQ 64 GII.13 Hu/GII. BAQ94581 MKMASNDAAPSNDGAASLVPEAINETMPLEPVAGASIAAPVAGQTN n.a. n.a. n.a. 13/10N4555/ IIDPWIRTNFVQAPNGEFTVSPRNSPGEILLNLELGPDLNPYLAHL 2010/NP SRMYNGYAGGVEVQVLLAGNAFTAGKILFAAIPPNFPVDMISPAQI TMLPHLIVDVRTLEPIMIPLPDVRNVEYHENNQPQPRMRLVAMLYT PLRSNGSGDDVFTVSCRVLTRPTPDFEFIYLVPPSVESKTKPFTLP ILTISELINSRFPIPIEQLYTAPNENNVVQCQNGRCTLDGELQGTT QLLSSAVCSYRGRTVANRGDNWDQNLLQLTYPSGASYDPTDEVPAP LGTQDFSGILYGVLTQDNVSEGTGEAKNAKGVYISTTSGKFTPKIG SIGLHSITENVHPNQQSRFTPVGVAQNENTPFQQWVLPHYAGALAL NTNLAPAVAPTFPGEQLLFFRSRVPCVQGLRGQDAFIDCLLPQEWV NHFYQEAAPSQADVALIRYVNPDTGRTLFEAKLHRSGFITVSHTGA YPLVVPPNGHFRFDSWVNQFYS 65 GII.14 JP/2007/ AII73780 MKMASNDATPSDDGAAGLVPEINSEVMALEPVAGASIAAPVVGQQN pICH99872 Yes Yes Fukuoka/ IIDPWIRNNFVQAPAGEFTVSPRNSPGELLLDLELGPELNPYLAHL KK282 ARMYNGHAGGMEVQIVLAGNAFTAGKILFAAIPPSFPYENLSPAQL TMCPHVIVDVRQLEPVLLPMPDIRNVFYHYNQNNSPKLRLVAMLYT PLRANNSGDDVFTVSCRVLTRPSPDFQFTFLVPPTVESKTKNFTLF VLRVSEMTNSRFPVVLDQMYTSRNENTIVQPQNGRCTTDGELLGTT ILQSVSICNFKGTMQAKLNEEPRYQLQLTNLDGSPIDPTDDMPAPL GTPDFQAVLYGVASQRSSRDNATRAHDAQIDTAGDTFAPKIGQVRF KSSSNDFDLHDPTKFTPIGVNVDDQHPFRQWSLPNYGGHLALNNHL APAVTPLFPGEQILFFRSYIPSAGGHTDGAMDCLLPQEWVEHFYQE AAPSQSDIALVRFINPDTGRVLFEAKLHKQGFLTIAASGDHPIVMP TNGYFRFEAWVNPFYTLAPVGTGSGRRRIQ 66 GII.14 NLV/M7/ AAN05735 MKMASNDATPSDDGAAGLVPEINNEVMALEPVAGASIAAPVVGQQN n.a. n.a. n.a. 1999/US IIDPWIRNNFVQAPAGEFTVSPRNSPGELLLDLELGPELNPYLAHL ARMYNGHAGGMEVQIVLAGNAFTAGKILFAAIPPSFPYENLSPAQL TMCPHVIVDVRQLEPVLLPMPDIRNVEYHYNQNNSPKLRLVAMLYT PLRANNSGDDVFTVSCRVLTRPSPDFQFTFLVPPTVESKTKNFTLP VLRVSEMTNSRFPVVLDQMYTSRNENIIVQPQNGRCTTDGELLGTT TLQSVSICNFRGTMQAKLNEQPRYQLQLTNLDGSPIDPTDDMPAPL GTPDFQAMLYGVASQRSSRDNATRAHDAQIDTAGDTFAPKIGQVRF KSSSDDFDLHDPTKFTPIGVNVDDQHPFRQWSLPNYGGHLALNNHL APAVTPLEPGEQILFFRSHIPSAGGHTDGAIDCLLPQEWIEHFYQE AAPSQSDIALVRFINPDTGRVLLEAKLHKQGFLTVAASGDHPIVMP TNGYFRFEAWVNPFYTLAPVGTGSGRRRIQ 67 GII.17 C142/1978/ AGI17592 MMMASNDAAPSNDGATGLVPEINHETLPLEPVAGAAIAAPVTGQNN pICH99887 Yes n.t. GUF IIDPWIRTNEVQAPNGEFTVSPRNSPGEILLNLELGPDLNPYLAHL SRMYNGYAGGVEVQVLLAGNAFTAGKILFAAVPPNFPVEFLSPAQI TMLPHLIVDVRTLEPIMIPLPDVRNTFFHYNNQPANRMRLVAMLYT PLRSNGSGDDVFTVSCRVLTRPTPDFEFTYLVPPSVESKTKPFSLP ILTISELTNSRFPAPIDSLYTAQNNNLNVQCQNGRCTLDGELQGTT QLLPSGICAFRGKLTADVHQSHDDRWHMQLTNLNGTPFDPTEDVPA PLGTPDFTGLLFGVASQRNVVSNPNTTRAHEAVISTTSSQFVPKLG SINFGSTSDDFQLQQPTKFTPVGIKVESGHDFDQWALPRYSGHLTL NMNLAPPVAPNFPGEQLLFFRSNVPCAGGVSDGVIDCLLPQEWIQY FYQESAPSQSDVALIRYVNPDTGRTLFEAKLARTGYITVAHSGDYP LVVPSNGYFREDSWVNQFYSLAPMGTGNGRRRVQ 68 GII.17 JP/2013/ BAR63715 MKMASNDAAPSNDGAAGLVPEGNNETLPLEPVAGAAIAAPVTGQNN pICH99890 Yes Yes Saitama5203 IIDPWIRTNEVQAPNGEFTVSPRNSPGEILLNLELGPDLNPYLAHL SRMYNGYAGGVEVQVLLAGNAFTAGKILFAAVPPNFPVEFLSPAQI TMLPHLIVDVRTLEPIMIPLPDVRNTFFHYNNQPNSRMRLVAMLYT PLRSNGSGDDVFTVSCRVLTRPTPDFEFTYLVPPSVESKTKPFSLP ILTLSELINSRFPVPIDSLFTAQNNVLQVQCQNGRCTLDGELQGTT QLLPSGICAFRGRVTAETDHRDKWHMQLQNLNGTTYDPTDDVPAPL GTPDFKGVVFGVASQRNVGNDAPGSTRAHEAVISTYSPQFVPKLGS VNFRSNDNDFQLQPTKFTPVGINDDGDHPFRQWELPDYSGLLTLNM NLAPPVAPNFPGEQLLFFRSFVPCSGGYNQGIVDCLIPQEWIQHEY QESAPSQSDVALIRYVNPDTGRTLFEAKLHRSGYITVAHSGDYPLV VPANGYFREDSWVNQFYSLAPMGTGNGRRRAQ 69 GII.17 JP/2015/ BAR42289 MKMASNDAAPSNDGAAGLVPEGNNETLPLEPVAGAAIAAPVTGQNN pICH99909 Yes Yes Kawasaki308 LIDPWIRTNEVQAPNGEFTVSPRNSPGEILLNLELGPDLNPYLAHL SRMYNGYAGGVEVQVLLAGNAFTAGKILFAAVPPNFPVEFLSPAQI TMLPHLIVDVRTLEPIMIPLPDVRNTFFHYSNQPNSRMRLVAMLYT PLRSNGSGDDVFTVSCRVLTRPTPDFEFTYLVPPSVESKTKPFSLP ILTLSELTNSRFPVPIDSLFTAQNNVLQVQCQNGRCTLDGELQGTT QLLPTGICAFRGRVTAQINQRDRWHMQLQNLNGTTYDPTDDVPAPL GTPDFKGVVFGMVSQRNVGNDAPGSTRAQQAWVSTYSPQFVPKLGS VNLRISDNDDFQFQPTKFTPVGVNDDDDGHPFRQWELPNYSGELTL NMNLAPPVAPNFPGEQLLFFRSFVPCSGGYNQGIIDCLIPQEWIQH FYQESAPSQSDVALIRYVNPDTGRTLFEAKLHRSGYITVAHSGDYP LVVPANGHFREDSWVNQFYSLAPMGTGNGRRRAQ 70 GII.17 JP/2002/ AII73747 MKMASNDAAPSNDGATGLVPEINNETLPLEPVAGAAIAAPVTGQNN pICH99912 Yes Yes Saitama/T87 IIDPWIRTNEVQAPNGEFTVSPRNSPGEILLNLELGPDLNPYLAHL SRMYNGYAGGVEVQVLLAGNAFTAGKILFAAVPPNFPVEFLSPAQI TMLPHLIVDVRTLEPIMIPLPDVRNTFFHYNNQPANRMRLVAMLYT PLRSNGSGDDVFTVSCRVLTRPTPDFEFTYLVPPSVESKTKPFSLP QLLPSGICAFRGRLTADVDGSHDDRWHMQLTNINGTPFDPTEDVPA PLGTPDFTGLLFGVASQRNVGSNPNTTRAHEAVISTTSSQFVPKLG SVNFGSTSTDFQLQQPTKFTPVGIKIESGHEFDQWALPRYSGHLTL NMNLAPPIAPNFPGEQLLFFRSNVPCAGGVSDGVIDCLLPQEWIQH FYQESAPSQSDVALIRYVNPDTGRTLFEAKLHRTGYITVAHSGDYP LVVPSNGYFREDSWVNQFYSLAPMGTGNGRRRVQ 71 GII.17 E11161 AQQ30449 MKMASNDAAPSNDGAAGLVPEGNNETLPLEPVAGAAIAAPVTGQNN n.a. n.a. n.a. IIDPWIRTNEVQAPNGEFTVSPRNSPGEILLNLELGPDLNPYLAHL SRMYNGYAGGVEVQVLLAGNAFTAGKILFAAVPPNFPVEFLSPAQI TMLPHIIVDVRTLEPIMIPLPDVRNTFFHYNNQPNSRMRLVAMLYT PLRSNGSGDDVFTVSCRVLTRPTPDFEFTYLVPPSVESKTKPFSLP ILTLSELTNSRFPVPIDSLFTAQNNVLQVQCQNGRCTLDGELQGTT QLLPSGICAFRGRVTAETDNPDKWHMQLQNLNGTTYDPTDDVPAPL GTPDFKGVVFGVASQRNVGNDAPGSTRAHEAVISTYSPKFVPKLGS VNERSNDDDFQLQPTRFTPVGINDDGNHPFRQWELPDYSGVLTLNM NLAPPVAPNFPGEQLLLFRSFVPCSGGYNQGIIDCLIPQEWIQHFY QESAPSQSDVALIRYVNPDTGRTLFEAKLHRSGYITVAHSGDYPLV VPANGYFRFDSWVNQFYSLAPMGTGNGRRRAQ 72 GII.21 Hu/GII21/ ALP48670 MKMASNDAAPSNDGAAGLVPEINTETLPLEPVAGAAIAAPVTGQNN n.a. n.a. n.a. CUHK-NS- IIDPWIRNNFVQAPNGEFTVSPRNSPGEILMNLELGPDLNPYLAHL 290/HKG/ SRMYNGYAGGVEVQVLLAGNAFTAGKILFAAVPPNFPVDMLSPAQI 2014 TMLPHLIVDVRTLEPIMIPLPDVRNVFYHENNQPAPRMRLVAMLYT PLRSNGSGDDVFTVSCRVLTRPTPDFEFTYLVPPSVESKTKPFTLP ILTIGELINSRFPAPIDQLYTSPNADVVVQPQNGRCTLDGELQGTT QLLTTAICSYRGTTSNPTSDYWDDHLLHLVHPNGATYDPTEDVPAP FGTQDERGILYGVLTQNTQNPRDEVSNSRGIYISSTSDKFTPKLGT IGLHQVQGDTASNQQSKFTPVGIAVNQNTPFKQWELPNYSGALTLN TNLAPAVGPNFPGEQILFFRSNVPSVQGNHPTQEIDCLIPQEWISH FYQESAPSQSDVALVRYVNPDTGRTIFEAKLHRQGFITIAATGSNP VVVPPNGYFREDSWVNQFYALAPMGTGNGRRRAQ 73 GII.22 BD/2012/ AUD54981 MKMASNDAAPSNDGAAGLVPEINTEVMALEPVAGGAIAAPLTGQTN n.a. n.a. n.a. GII.P22- IIDPWIRNNEVQAPNGEFTISPRNSPGEILLNMELGPELNPFLAHL GII.22/ SRMYNGFAGGMEVQVLMAGNAFTAGKVIFAAIPPHFPVENLSPPQI Dhaka1940 TMFPHIIIDVRTLEPVLLPMPDVRNQFFHYNQVNEPRMRLVAMLYT PLRSNGSTEDVFTVSCRVLTRPSPDFEFNYLVPPTVESRTKPFTLP ILTIGEMTNSRFPAPIDMLYTSPNDNVVVQPQNGRCTLDGELQGST QLVPANVCAFKGKITARIVDQAAHQWHMQIDNPNGTLFDPTEDVPA PLGTPDFKAKIFGVISQRNDYNDGSQGPANRAHDAVVPTTSAKFTP KLGSILVGTWENNDIETQPSKFTPVGLLEMNDENQWSLPNYSGALT LNMGLAPAVFPTFPGEQILFFRSFIPLKGGHGNPAIDCLLPQEWIQ HEYQESAPSQTSVALIRYVNPDTGRVLFEGKLHRQGFITIAKSGDG PIVVPPNGYFRFDSWVNQFYSLAPMGNGNGRRRIQ 74 GII.24 PE/2014/ AUD54978 MKMASNDAAPSNDGAANLVPEANKEVMALEPVAGGAIAAPLTGQTN n.a. n.a. n.a. GII.P24- IIDPWIMNNFVQAPNGEFTISPRNSPGEVLLNLELGPDLNPFLAHL GII.24/ SRMYNGYAGGVEVQVIMAGNAFTAGKVIFAAVPPHFPVDNLSPPQV Loreto6424 TMFPHVIVDVRTFEPILLPLPDVRNSFYHYNQVNDSRMRLIAMLYT PLRSNGSSDDVFTVSCRVLTRPTPDFEFNYLVPPTVESRTKPFSVP ILTIGEMTNSRFPLPIDMLYTSPTENIVVQPQNGRCTLEGELLGTT QLVTPNICALRGEIRGHEGSGDNHKWHFMVRSPNGAAFDPTEDVPA PLGTPDFIGDVFGVLSQRNENTDSGQSGPANRSHDAVVSTRDSRFT PKLGSVMIATWETSDIQDQPTRFTPVGLENPDHYNQWQLPNYSGAL TLNMGLAPSVFPTYPGEQILFFRSYIPLKGGYGDSHIDCLVPQEWI QHFYQESAPSQTDVALIRYVNPETGRVLFEAKLHRQGYITVARSGS SPINVPANGYFREDSWVNQFYSLAPMGTGNGRRRIQ 75 GII.25 BD/2012/ AUD54984 MKMASNDAAPSNDGAAGLVPEINNEVMALEPVAGGAIAAPLTGQTN n.a. n.a. n.a. GII.P22- VIDPWIRTNEVQAPNGEFTISPRNSPGEVLLNMELGPELNPFLGHI GII.25/ SRMYNGYAGGIEVQVLMAGNAFTAGKVIFAAVPPHFPVENLSPPQV Dhaka1928 TMFPHIIVDVRTLEPILLPLPDVRNQFFHYSQVDEPKMRLVAMLYT PLRSNGSAEDVFTVSCRVLTRPSPDFEFNYLVPPTVESRTKPFTVP ILTIGEMSNSRFPAPIDMLYTSPNDNQNVQPQNGRCTLDGELQGTT QLVPSGVCAFRGRITGHEGSEQNQWHMQLININGTPFDPTEDIPAP LGTPDFKGEIFGFISQRNAQNDPGQSQPANRAHDAVVSTRAPKFTP KLGSVMIGTWVNSDIENQPSKFTPVGLNSNENFRQWELPDYSGVLT LNMGLAPVVHPTYPGEQILFFRSYIPLKGGHGNPAIDCLLPQEWIQ HEYQESAPSQTDVALLRYVNPDTGRVLFEAKLHRQGYITIAKSGDG PIVVPPNGYFRFDSWVNQFYSLAPMGNGNGRRRVQ 76 GIV.1 Ahrens AFN61315 MKMASSDAAPSADGAGNLVPESQQEVLPLAPVAGAALAAPVVGQTN pICH99924 Yes Yes hoop246/ IIDPWIKENFVQAPQGEFTVSPKNSPGEILVNLELGPKLNPYLDHL DEU/2012 SRMYNSYAGGIDVMVVLAGNAFTAGKVLIAAIPPNFPVEGVSASQA TQFPHVIIDVRTLDPVRLPLPDVRSTFFHYTNDTEPKMRLVIWLYT PLRINGSGDDSFTVSGRILTRPSQDFEFAFLIPPTVETKTTPFSVP GFSVQEMSNSRWPAAISAMVVRGNEPQVVQFQNGRAHLDGMLLGTT PVSPNYIASYRGISTGNSRSASSEADERAVGSFDVWIRLQEPDGQP YDIFGKQPAPIGTPDFKAVIVGFAARPLTSGSYANEAYVNTTASDY APATGNMRFTVRNGGTGHISANKYWEFRSFGVEGERHTDVQYQEYE LPDYSGQVASNHNLAPPVAPRMPGESLLLFQSNMPVWDDGRGESTP KKIHCLLPQEFIGHFFDKQAPSLGDAALLRYVNQETNRVLFECKLY RDGYITVAAASGLLDFPLDGFFREDSWVSSFYILSPVGSGQGRRGR VRFQ 77 GIV.1 Lake YP_ MKMASSDAAPSTDGAGNLVPESQQEVLPLAPVAGAALAAPVVGQTN n.a. n.a. n.a. Macquarie/ 009237904 IIDPWIKENFVQAPQGEFTVSPKNSPGEILVNLELGPKLNPYLDHL NSW2680/ SRMYNSYAGGIDVMVVLAGNAFTAGKVLIAAIPPNFPVEGVSASQA 2010/AU TQFPHVIIDVRTLDPVRLPLPDVRSTFFHYTNDTEPKMRLVIWLYT PLRINGSGDDSFTVSGRILTRPSQDFEFAFLIPPTVETKTTPFSVP GFSVQEMSNSRWPAAISAMVVRGNEPQVVQFQNGRAHLDGMLLGTT PVSPNYLASYRGISTGNSRSASSEADERAVGSFDVWVRLQEPDGQP YDIFGKQPAPIGTPDFKAVIVGFAARPLTSGSYANEAYVNTTASDY APATGNMRFTVRNGGTGHISANKYWEFKSEGVEGERHTDIQYQEYE LPDYSGQVASNHNLAPPVAPRMPGESLLLFQSNMPVWDDGHGESTP KKIHCLLPQEFIGHFFDRQAPSLGDAALLRYVNQETNRVLFECKLY RDGYITVAASSGLLDFPLDGFFRFDSWVSSFYILSPVGSGQGRRGR VRFQ 78 GIV.3 USA/2016/ APA31973 MKMASNDAPPSSDGAGNLVPESHQEVLPLAPVAGAELAAPVVGQTN n.a. n.a. n.a. W17002 IIDPWIKENFVQAPQGEFTVSPKNAPGEILVNLELGPNLNPYLEHL SRMYNAYAGGIEVELILAGNAFTAGKILIAAVPPNFPVESVSASQA TQFPHAIVDVRTLEPVRLPLPDVRSNFFHYTTKDEPKMRLVIWLYT PLRINGSGDDSFTVSGRLLTRPSMDFQFSFLVPPTVETKTVLFTVP GLTPQEMSNSRWPAQISGMVVRGNEPQVVQFQNGRCHTDGTLLGTT TVSEQCIAGFVGTSTNTRSATGSTTETRTGDTDLWLRLEEPNGQPY DIFGDQPAPLGTPDFRAVIVGFASRPQTQGSYMNEAYVNTVDSHFA PATGNTKIILRRGGTGHVGGGHLWKFRPFGVEGGEGRVSYQEYVLP NYSGATASNHNLAPPVAPRMPGELLLLFESDMPVWDDGHGAAPAQK IHCLLPQQFITHFFDSQAPALAEAALLRYVHPDSSRVLFETKLYRE GFMVVSAPTGRFDFPLDGYFRFDSWVNSFYVLSPVGSGQGRRGRSK VV *Presence of Virus-like particles confirmed by transmission electron microscopy; n.a .: not applicable; n.t .: not tested

TABLE 2 Cholera enterotoxin subunit B sequences. Mutations and modifications are indicated in the amino acid sequences in bold. SEQ ID Expression No. Description Sequence host Reference 79 Cholera enterotoxin TPQNITDLCA Prokaryotic Acc. no.: subunit B sequence from YHNTQIHTL Eukaryotic P01556 Vibrio cholerae O1 biovar NDKIFSYTES El Tor str. N16961, mature AGKREMAII protein TFKNGATFQV VPGSQHIDS QKKAIERMKD LRIAYLTEA KVEKLCVWNN TPHAIAAIS MAN 80 T1C/T92C mutations for CPQNITDLCA Prokaryotic 1 generation of inter-subunit YHNTQIHTL Eukaryotic disulfide crosslinks NDKIFSYTES AGKREMAII TFKNGATFQV VPGSQHIDS QKKAIERMKD LRIAYLTEA KVEKLCVWNN CPHAIAAIS MAN 81 S100T mutation for TPQNITDLCA Prokaryotic 2 improved yield YHNTQIHTL Eukaryotic NDKIFSYTES AGKREMAII TFKNGATFQV VPGSQHIDS QKKAIERMKD LRIAYLTEA KVEKLCVWNN TPHAIAAIT MAN 82 T1C/T92C mutations for CPQNITDLCA Prokaryotic 1, 2 generation of inter-subunit YHNTQIHTL Eukaryotic disulfide crosslinks and NDKIFSYTES S100T mutation for AGKREMAII improved yield TfKNGATFQV VPGSQHIDS QKKAIERMKD LRIAYLTEA KVEKLCVWNN CPHAIAAIT MAN 83 N-terminal tag 6xHis-tag MGSSHHHHHH Prokaryotic and T7-tag with thrombin SGLVPRGSH cleavage sites MASMTGGQQM GRGSEFRT TPQNITDLCA YHNTQIHTL NDKIFSYTES AGKREMAII TFKNGATFQV VPGSQHIDS QKKAIERMKD LRIAYLTEA KVEKLCVWNN TPHAIAAIS MAN 84 N-terminal tag 6xHis-tag MHHHHHHSSG DDDDKG Prokaryotic and enterokinase cleavage TPQNITDLCA Eukaryotic site YHNTQIHTL NDKIFSYTES AGKREMAII TFKNGATFQV VPGSQHIDS QKKAIERMKD IRIAYLTEA KVEKLCVWNN TPHAIAAIS MAN 85 N4S mutation to remove a TPQSITDLCA Eukaryotic 3, 4, 5 N-glycosylation site YHNTQIHTI NDKIFSYTES AGKREMAII TFKNGATEQV VPGSQHIDS QKKAIERMKD LRIAYLTEA KVEKLCVWNN TPHAIAAIS MAN 86 N4S mutation to remove a TPQSITDLCA Eukaryotic 4, 5 N-glycosylation site and C- YHNTQIHTL terminal ER-retention NDKIFSYTES signal AGKREMAII TFKNGATFQV VPGSQHIDS QKKAIERMKD LRIAYLTEA KVEKLCVWNN TPHAIAAIS MANSEKDEL 87 C-terminal ER-retention TPQNITDLCA Eukaryotic 3, 5 signal YHNTQIHTL NDKIFSYTES AGKREMAII TFKNGATFQV VPGSQHIDS QKKAIERMKD LRIAYLTEA KVEKLCVWNN TPHAIAAIS MANSEKDEL 88 N4S mutation to remove a CPQSITDLCA Eukaryotic 1, 3, 5 N-glycosylation site and YHNTQIHTL T1C/T92C mutations for NDKIFSYTES generation of inter-subunit AGKREMAII disulfide crosslinks TFKNGATFQV VPGSQHIDS QKKAIERMKD LRIAYLTEA KVEKLCVWNN CPHAIAAIS MAN 89 N4S mutation to remove a TPQSITDLCA Eukaryotic 2, 3, 5 N-glycosylation site and YHNTQIHTL S100T mutation for NDKIFSYTES improved yield AGKREMAII TFKNGATEQV VPGSQHIDS QKKAIERMKD LRIAYLTEA KVEKLCVWNN TPHAIAAIT MAN 90 N4S mutation to remove a CPQSITDLCA Eukaryotic 1, 2, 3, 5 N-glycosylation site, YHNTQIHTL T1C/T92C mutations for NDKIFSYTES generation of inter-subunit AGKREMAII disulfide crosslinks and TFKNGATFQV S100T mutation for VPGSQHIDS improved yield QKKAIERMKD LRIAYLTEA KVEKLCVWNN CPHAIAAIT MAN 91 T1C/T92C mutations for CPQNITDLCA Eukaryotic 1, 3, 4, 5 generation of inter-subunit YHNTQIHTL disulfide crosslinks and C- NDKIFSYTES terminal ER-retention AGKREMAII signal TFKNGATFQV VPGSQHIDS QKKAIERMKD LRIAYLTEA KVEKLCVWNN CPHAIAAIS MANSEKDEL 92 S100T mutation for TPQNITDLCA Eukaryotic 2-5 improved yield and C- YHNTQIHTL terminal ER-retention NDKIFSYTES signal AGKREMAII TEKNGATFQV VPGSQHIDS QKKAIERMKD LRIAYLTEA KVEKLCVWNN TPHAIAAIT MANSEKDEL 93 T1C/T92C mutations for CPQNITDLCA Eukaryotic 1-5 generation of inter-subunit YHNTQIHTL disulfide crosslinks and NDKIFSYTES S100T mutation for AGKREMAII improved yield and C- TFKNGATFQV terminal ER-retention VPGSQHIDS signal QKKAIERMKD LRIAYLTEA KVEKLCVWNN CPHAIAAIT MANSEKDEL 94 N4S mutation to remove a CPQSITDLCA Eukaryotic 1, 4, 5 N-glycosylation site, YHNTQIHTL T1C/T92C mutations for NDKIFSYTES generation of inter-subunit AGKREMAII disulfide crosslinks and C- TFKNGATFQV terminal ER-retention VPGSQHIDS signal QKKAIERMKD LRIAYLTEA KVEKLCVWNN CPHAIAAIS MANSEKDEL 95 N4S mutation to remove a TPQSITDLCA Eukaryotic 2-5 N-glycosylation site, YHNTQIHTL S100T mutation for NDKIFSYTES improved yield and C- AGKREMAII terminal ER-retention TFKNGATFQV signal VPGSQHIDS QKKAIERMKD LRIAYLTEA KVEKLCVWNN TPHAIAAIT MANSEKDEL 96 N4S mutation to remove a CPQSITDLCA Eukaryotic 1-5 N-glycosylation site YHNTQIHTL T1C/T92C mutations for NDKIFSYTES generation of inter-subunit AGKREMAII disulfide crosslinks and TFKNGATFQV S100T mutation for VPGSQHIDS improved yield and C- QKKAIERMKD terminal ER-retention LRIAYLTEA signal KVEKLCVWNN CPHAIAAIT MANSEKDEL 1: Miyata T., Oshiro S., Harakuni T., Taira T., Matsuzaki G., Arakawa T. Physicochemically stable cholera toxin B subunit pentamer created by peripheral molecular constraints imposed by de novo-introduced intersubunit disulfide crosslinks. Vaccine. 2012 Jun. 13; 30(28): 4225-32. 2: Bakhshi B., Boustanshenas M., Ghorbani M. A single point mutation within the coding sequence of cholera toxin B subunit will increase its expression yield. Iran Biomed J. 2014 July; 18(3): 130-5. PubMed PMID: 24842138; PubMed Central PMCID: PMC4048476. 3: Hamorsky K.T., Kouokam J.C., Bennett L.J., Baldauf K.J., Kajiura H., Fujiyama K., Matoba N. Rapid and scalable plant-based production of a cholera toxin B subunit variant to aid in mass vaccination against cholera outbreaks. PLoS Negl Trop Dis. 2013; 7(3): e2046. 4: Hamorsky K.T., Kouokam J.C., Jurkiewicz J.M., Nelson B., Moore L.J., Husk A.S., Kajiura H., Fujiyama K., Matoba N. N-glycosylation of cholera toxin B subunit in Nicotiana benthamiana: impacts on host stress response, production yield and vaccine potential. Sci Rep. 2015 Jan. 23; 5: 8003. 5: US20140286986, Title: Polypeptides having immunoactivating activity and methods of producing the same, Published: 25. Sep. 2014, Applicant: University Of Louisville Research Foundation, Inc.

TABLE 3 Escherichia coli Heat-labile enterotoxin subunit B sequences. Mutations and modifications are indicated in the amino acid sequences in bold. SEQ ID No. Description Sequence Reference 97 Escherichia coli Heat- APQTITELCS Acc. no.: labile enterotoxin B EYRNTQIYTI P32890 chain, porcine NDKILSYTES MAGKREMVII TFKSGETFQV EVPGSQHIDS QKKAIERMKD TLRITYLTET KIDKLCVWNN KTPNSIAAIS MKN 98 Escherichia coli O78: H11 APQSITELCS Acc. no.: (strain H10407 / ETEC) EYRNTQIYTI D0Z6T1 Heat-labile enterotoxin B NDKILSYTES chain MAGKREMVII TFKSGATFQV EVPGSQHIDS QKKAIERMKD TLRITYLTET KIDKLCVWNN KTPNSIAAIS MEN 99 Escherichia coli O78: H11 APQSITELCS Derived (strain H10407 / ETEC) EYRNTQIYTI from acc. Heat-labile enterotoxin B NDKILSYTES no.: chain with C-terminal MAGKREMVII D0Z6T1 ER-retention signal TFKSGATFQV EVPGSQHIDS QKKAIERMKD TLRITYLTET KIDKLCVWNN KTPNSIAAIS MENSEKDEL 100 Escherichia coli Heat- APQSITELCS Acc. no.: labile enterotoxin B EYHNTQIYTI P0CK94 chain, human NDKILSYTES MAGKREMVII TFKSGATFQV EVPGSQHIDS QKKAIERMKD TLRITYLTET KIDKLCVWNN KTPNSIAAIS MEN

The content of European patent applications No. 18 157 031.8 and No. 18 215 676.0, filed on Feb. 15, 2018 and Dec. 21, 2018, respectively, is incorporated herein including entire descriptions, claims and figures. 

1. A method of preventing and/or treating norovirus infection and/or for reducing the severity of norovirus infection, said immunogenic composition comprising at least one norovirus antigen and at least one B subunit of an AB₅ toxin to a subject by parenteral administration of the immunogenic composition selected from intradermal, intramuscular and subcutaneous administration, wherein said B subunit is a B subunit of cholera toxin (CTB).
 2. The method according to claim 1, wherein said composition is free of the A subunit of said toxin.
 3. The method according to claim 1, wherein said B subunit is an adjuvant of said composition.
 4. The method according to claim 1, wherein said B subunit is an antigen, and said at least one norovirus antigen and said B subunit are components of a combination vaccine.
 5. The method according to claim 1, wherein said at least one norovirus antigen is or comprises a norovirus VP1 protein.
 6. The method according to claim 1, said immunogenic composition comprising an antigen of a genogroup I norovirus and an antigen of a genogroup II norovirus.
 7. The method according to claim 1, wherein said immunogenic composition comprises norovirus virus-like particles (norovirus VLPs) comprising or consisting of said at least one norovirus antigen.
 8. The method according to claim 1, wherein said immunogenic composition comprises VLPs of a genogroup I norovirus and VLPs of a genogroup II norovirus.
 9. The method according to claim 1, wherein said CTB is pentameric CTB.
 10. The method according to claim 1, said immunogenic composition comprising two or more genogroup II noroviral antigens, wherein a first VLP comprises or consists of a first genogroup II noroviral antigen and a second VLP comprises or consists of a second genogroup II noroviral antigen.
 11. The method according to claim 1, said immunogenic composition comprising a genotype 11.4 noroviral antigen and a genotype II.17 noroviral antigen.
 12. The method according to claim 1, said immunogenic composition comprising VLPs comprising or consisting of a genogroup I noroviral antigen, VLPs comprising or consisting of a genogroup 11 noroviral antigen, and CTB as an adjuvant.
 13. The method according to claim 1, said immunogenic composition comprising VLPs comprising or consisting of a genotype I.1 or 1.4 noroviral antigen, VLPs comprising or consisting of a genotype II.4 noroviral antigen, and CTB as an adjuvant.
 14. The method according to claim 8, said immunogenic composition comprising said genogroup I noroviral antigen and said genogroup II noroviral antigen in a mass ratio range of from 1:1 to 1:6, preferably of from 1:1.5 to 1:5, more preferably of from 1:2 to 1:4.
 15. The method according to claim 1, said composition not comprising an aluminum salt, such as aluminum hydroxide.
 16. The method according to claim 1, said method being for preventing and/or treating and/or for reducing the severity of norovirus infection in a mammal.
 17. A method for preventing and/or treating Norovirus infection and infection by a bacterial pathogen in a mammal, comprising administering to a subject an immunogenic composition comprising at least one noroviral antigen and a B subunit of a bacterial AB₅ toxin capable of generating an immune response against said bacterial pathogen, wherein said B subunit of a bacterial AB₅ toxin is a B subunit of cholera toxin (CTB).
 18. The method according to claim 17, comprising parenteral administration of the immunogenic composition, such as intradermal, intramuscular or subcutaneous administration.
 19. An anti-norovirus vaccine or a pharmaceutical composition, comprising the immunogenic composition as defined in claim 1 and a pharmaceutically acceptable carrier.
 20. Combination vaccine for preventing and/or treating Norovirus infection and infection by a bacterial pathogen in a mammal, said vaccine comprising a noroviral antigen and a B subunit of a bacterial AB₅ toxin capable of generating an immune response against said bacterial pathogen, and a pharmaceutically acceptable carrier, wherein said B subunit of a bacterial AB₅ toxin is a B subunit of cholera toxin (CTB). 